Reservoir Medical Associates, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

57930 Issued in MA

Legal business name

RESERVOIR MEDICAL ASSOCIATES, P.C.

Practice address

725 Concord Ave
Suite 2000
Cambridge, MA 02138-1040

Phone

(617) 661-4600

Fax

(617) 547-9170

NPI assigned

May 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Debra Shapiro, MDNPI 1194775262

Title

Owner

Phone

(617) 661-4600

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Debra Shapiro, MD

  • Internal Medicine Physician
  • Cambridge, MA
  • NPI 1194775262
  Medicare reassignment Care Compare group Authorized official
• Kimberly Ann Goc, NP

  • Gerontology Nurse Practitioner
  • Cambridge, MA
  • NPI 1518916519
  Medicare reassignment Care Compare group NPD
• Johanna Murphy

  • Family Nurse Practitioner
  • Cambridge, MA
  • NPI 1316702426
  Medicare reassignment Care Compare group NPD
• Maryn Kramerz, FNP-BC

  • Family Nurse Practitioner
  • Cambridge, MA
  • NPI 1487396016
  Medicare reassignment NPD

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1356399562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 CONCORD AVE",
            "address_2": "SUITE 2000",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381040",
            "telephone_number": "617-661-4600",
            "fax_number": "617-547-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 CONCORD AVE",
            "address_2": "SUITE 2000",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381040",
            "telephone_number": "617-661-4600",
            "fax_number": "617-547-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESERVOIR MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-661-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "57930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9776036",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "609088",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M16171",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Renfrow
• M. Suzanne Renna, ED.D., MHC
• Carol Norris Renneburg, MD
• Allison Rense, DPT
• Yisshelen Renteria Salazar
• Rethink Minds LLC
• Retina Specialists of Boston, Inc.
• Kayla Revallion
• Nathaniel Rex, MD
• Jason D Reynolds

• Internal Medicine Physician in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.