Individual provider Active NPI

James Shay

  • Nurse Practitioner
  • Quincy, MA
National Provider Identifier
1164757779
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN273649 Issued in MA
Practice address
1250 Hancock St
Quincy, MA 02169-4339
Phone
(617) 421-2686
Fax
(617) 774-0606
NPI assigned
Oct 15, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN273649 MA Primary

Addresses

Primary practice location

1250 Hancock St
Quincy, MA 02169-4339

Mailing address

1250 Hancock St FL 5
Quincy, MA 02169-4339
Phone (617) 421-2686

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160629001329 MA Practitioner - Nurse Practitioner 6901197573 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Perfect Health PC CurrentSince Sep 15, 2020 Accepting new patients
Matrix Medical Plus Nurse Practitioner CurrentSince Mar 1, 2022 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

3 Allied Dr
Dedham, MA 02026
Phone (404) 587-0945

169 Madison Ave
Ste 2817
New York, NY 10016
Phone (917) 410-7931

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1164757779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 HANCOCK ST FL 5",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694339",
            "telephone_number": "617-421-2686",
            "fax_number": "617-774-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 HANCOCK ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694339",
            "telephone_number": "617-421-2686",
            "fax_number": "617-774-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAY",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-15",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN273649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.