Jessica Shim, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

277991 Issued in MA

Practice address

333 Longwood Ave # Lo-545
Boston, MA 02115-5711

Phone

(617) 355-7648

NPI assigned

Jan 19, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Obstetrics/Gynecology

Education

Northwestern University Feinberg Medical School, 2015

Medicare assignment

May accept Medicare assignment

Group practices

CHMC Surgical Gynecology GroupGroup PAC ID 2365866803, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshim23077@direct.bostonchildrens.org

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.

• CHMC Surgical Gynecology Group

  • Obstetrics & Gynecology Physician
  • Boston, MA
  • NPI 1295360824
  Medicare reassignment Care Compare group NPD
• CHMC Surgical Foundation Inc

  • Pediatric Surgery Physician
  • Boston, MA
  • NPI 1902977515
  Medicare reassignment NPD

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

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1275922916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 LONGWOOD AVE # LO-545",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155711",
            "telephone_number": "617-355-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LONGWOOD AVE # LO-545",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155711",
            "telephone_number": "617-355-7648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "512 N McClurg Ct",
            "address_2": "Apt 1704",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606115359",
            "country_code": "US",
            "telephone_number": "503-997-4919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIM",
        "first_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-19",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "277991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dmitry Shiktorov
• Chaitanya Shilagani, M.D.
• Dacia Shillingford-Compas
• Kathleen Elizabeth Shillue, PT, OCS
• Hong Gi Shim, MD
• Akiko Shimamura, MD, PHD
• Kaitlin Shimer-Uebbing, LICSW
• Sophia E Shimer, MD
• Naomi Shimizu, M.D.
• Shai Shimony, MD

• Obstetrics & Gynecology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Obstetrics & Gynecology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.