Individual provider Active NPI

Jan R Shoyer, M.D.

  • Pediatrics Physician
  • Somerville, MA
National Provider Identifier
1376523035
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
73160 Issued in MA
Practice address
40 Holland St
Somerville, MA 02144-2705
Phone
(617) 629-6300
Fax
(617) 629-6090
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 73160 MA Primary

Addresses

Primary practice location

40 Holland St
Somerville, MA 02144-2705

Mailing address

40 Holland St
Somerville, MA 02144-2705
Phone (617) 629-6300

Other identifiers 5

IdentifierTypeStateIssuer
J16087OtherMABLUE CROSS
073160OtherMATUFTS
0015153OtherMANEIGHBORHOOD HEALTH
PP412OtherMAHARVARD PILGRIM
3202593MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jshoyermd2004@direct.atrius.masshiway.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
73160MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jshoyermd2004@direct.atrius.masshiway.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1376523035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HOLLAND ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442705",
            "telephone_number": "617-629-6300",
            "fax_number": "617-629-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HOLLAND ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442705",
            "telephone_number": "617-629-6300",
            "fax_number": "617-629-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOYER",
        "first_name": "JAN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "73160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J16087",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "073160",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0015153",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "PP412",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3202593",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshoyermd2004@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "40 Holland St",
            "city": "Somerville",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021442705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.