Individual provider Active NPI

Jennifer Shark, CNM

  • Midwife
  • Cambridge, MA
National Provider Identifier
1205004793
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
RN2276775 Issued in MA
Practice address
25 Carleton St
Cambridge, MA 02142-1323
Phone
(617) 253-1315
Fax
(617) 258-0454
NPI assigned
Feb 18, 2008
Last updated
Jun 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X RN2276775 MA Primary

Addresses

Primary practice location

25 Carleton St
Cambridge, MA 02142-1323

Mailing address

25 Carleton St
Cambridge, MA 02142-1323
Phone (617) 253-1315

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121026000254 MA Practitioner - Certified Nurse Midwife (CNM) 2860562543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts Institute of TechnologyGroup PAC ID 5597658666, 55 clinicians

Practice addresses (Care Compare)

25 Carleton St
Cambridge, MA 02142-1323
Phone (617) 258-6896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN2276775MAMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Institute of Technology CurrentSince Feb 25, 2017 Accepting new patients
MMC OB/GYN Hospital Past Accepting new patients

Locations

25 Carleton St
Cambridge, MA 02142
Phone (617) 253-0556

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1205004793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CARLETON ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021421323",
            "telephone_number": "617-253-1315",
            "fax_number": "617-258-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CARLETON ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021421323",
            "telephone_number": "617-253-1315",
            "fax_number": "617-258-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARK",
        "first_name": "JENNIFER",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-18",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "MA",
            "license": "RN2276775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.