NPIMap

Organization Active NPI

Virginia M Shiller, PH.D., LLC

  • Psychologist
  • Lexington, MA
National Provider Identifier
1285927871
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1236 Issued in CT
Legal business name
VIRGINIA M SHILLER, PH.D., LLC
Practice address
55 Watertown St Unit 460
Lexington, MA 02421-6358
Phone
(203) 415-7160
Fax
(203) 776-3681
NPI assigned
May 16, 2011
Last updated
Sep 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Authorized official

Name
Dr. Virginia M Shiller, PH.D.NPI 1053460139
Title
Member
Phone
(203) 776-3681

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1236 CT Primary

Addresses

Primary practice location

55 Watertown St Unit 460
Lexington, MA 02421-6358

Mailing address

55 Watertown St Unit 460
Lexington, MA 02421-6358
Phone (203) 415-7160

Other identifiers 1

IdentifierTypeStateIssuer
004065801MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110711000244 CT Part B Supplier - Clinic/Group Practice 7113105479 Receives reassigned benefits from 1 practitioner
Practice locations: New Haven, CT
O20240723001937 MA Part B Supplier - Clinic/Group Practice 7113105479 Receives reassigned benefits from 1 practitioner
Practice locations: Cambridge, MA; Lexington, MA

National Provider Directory

National Provider Directory

Locations

147 Bishop St
New Haven, CT 06511
Phone (203) 393-8775

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1285927871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATERTOWN ST UNIT 460",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024216358",
            "telephone_number": "203-415-7160",
            "fax_number": "203-776-3681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WATERTOWN ST UNIT 460",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024216358",
            "telephone_number": "203-415-7160",
            "fax_number": "203-776-3681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA M SHILLER, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "SHILLER",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-776-3681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "1236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004065801",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.