Individual provider Active NPI

Weiru Shao, MD

  • Otolaryngology Physician
  • Cambridge, MA
National Provider Identifier
1164534343
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
220281 Issued in MA
Practice address
1493 Cambridge St
Surgery
Cambridge, MA 02139-1047
Phone
(617) 665-2555
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otology & Neurotology Physician 207YX0901X MD450439 PA
Otolaryngology Physician 207Y00000X 220281 MA Primary
Otology & Neurotology Physician 207YX0901X 220281 MA

Addresses

Primary practice location

1493 Cambridge St
Surgery
Cambridge, MA 02139-1047

Mailing address

1493 Cambridge St
Surgery
Cambridge, MA 02139-1047
Phone (617) 665-2555

Other identifiers 5

IdentifierTypeStateIssuer
8150376OtherCIGNA
3011586OtherHIGHMARK
PO1258059OtherRAILROAD MEDICARE
421692OtherUPMC HEALTH PLAN
7395417OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040708001134 MA Practitioner - Otolaryngology 3274511043 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Utah School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cambridge Public Health CommissionGroup PAC ID 8921910894, 654 clinicians

Practice addresses (Care Compare)

230 Highland Ave
Somerville, MA 02143-1408
Phone (617) 591-4500

Hospital & facility affiliations

  • Cambridge Health Alliance Hospital, Cambridge, MA, CCN 220011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
220281MAMDOtology & Neurotology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 1, 2018 Accepting new patients
Cambridge Public Health Commission CurrentSince Jul 20, 2015 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Otolaryngology CurrentSince Jul 1, 2018 Accepting new patients
Cambridge Public Health Commission Past Accepting new patients

Locations

750 Washington St
Boston, MA 02111
Phone (617) 636-4600

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

230 Highland Ave
Somerville, MA 02143
Phone (617) 591-4350

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1164534343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "address_2": "SURGERY",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047",
            "telephone_number": "617-665-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "address_2": "SURGERY",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047",
            "telephone_number": "617-665-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAO",
        "first_name": "WEIRU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "PA",
            "license": "MD450439",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "220281",
            "primary": true
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "MA",
            "license": "220281",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8150376",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "3011586",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "PO1258059",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC HEALTH PLAN",
            "identifier": "421692",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7395417",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.