Hiroshi Mashimo, M.D., PH.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

73215 Issued in MA

Practice address

1400 VFW Pkwy
Res 151 BLD 3
W Roxbury, MA 02132

Phone

(857) 203-5640

Fax

(857) 203-5666

NPI assigned

Sep 5, 2006

Last updated

Mar 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1073616348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "address_2": "RES 151 BLD 3",
            "city": "W ROXBURY",
            "state": "MA",
            "postal_code": "02132",
            "telephone_number": "857-203-5640",
            "fax_number": "857-203-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "address_2": "RES 151 BLD 3",
            "city": "W ROXBURY",
            "state": "MA",
            "postal_code": "02132",
            "telephone_number": "857-203-5640",
            "fax_number": "857-203-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHIMO",
        "first_name": "HIROSHI",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "73215",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "73215",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "#3139492",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in W Roxbury, MA
• Providers in W Roxbury, MA by specialty
• Gastroenterology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.