Pramodchandra C Shah, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

34904 Issued in MA

Practice address

365 Main St
Winthrop, MA 02152

Phone

(617) 846-5352

Fax

(617) 846-1062

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1316915465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 BLUE JAY RD",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "01940",
            "telephone_number": "781-581-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MAIN ST",
            "city": "WINTHROP",
            "state": "MA",
            "postal_code": "02152",
            "telephone_number": "617-846-5352",
            "fax_number": "617-846-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PRAMODCHANDRA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "34904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2008912",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandria Santiago, LICSW
• Bridget A Schulz, APRN
• Richard A Schwartz, D.M.D.
• Kristen M. Seashore, LICSW
• Secret Sauce Nutrition
• Nelly Shteynberg
• Josina Silva, LMT
• Heather Sinclair
• Ashley Jordan Solano, PT, DPT
• Kerry Lynn Spindler, LE

• Surgery Physician in Winthrop, MA
• Providers in Winthrop, MA by specialty
• Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.