Individual provider Active NPI

Shital Makim, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1396918496
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
237359 Issued in MA
Practice address
800 Washington St
Boston, MA 02111-1552
Phone
(617) 636-5000
NPI assigned
Apr 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 125-05-1880 IL
Diagnostic Radiology Physician 2085R0202X 237359 MA Primary

Addresses

Primary practice location

800 Washington St
Boston, MA 02111-1552

Mailing address

30, Cambridgepark Drive
Apt 8127
Cambridge, MA 02140
Phone (847) 343-4361

Other practice location 1

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-3850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081029000384 MA Practitioner - Diagnostic Radiology 1557429917 Reassigns benefits to 9 organizations
I20230901002872 NH Practitioner - Diagnostic Radiology 1557429917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pratt Radiology Associates IncGroup PAC ID 8820989411, 53 clinicians

Practice addresses (Care Compare)

Newton, MA 02460-1203
Phone (617) 643-0030

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 354-4181

102 Endicott St
Danvers, MA 01923-3623
Phone (978) 354-4181

15 Corporate Park Dr
Pembroke, MA 02359-1966
Phone (781) 826-8065

170 Governors Ave
Medford, MA 02155-1643
Phone (781) 395-4909

200 Route 108
Somersworth, NH 03878-1119
Phone (603) 740-2250

30 Tuscan Blvd
Salem, NH 03079-3981
Phone (857) 282-8100

4 Centennial Dr
Peabody, MA 01960-7935
Phone (978) 354-4181

480 Lynnfield St
Lynn, MA 01904-1419
Phone (781) 342-4386

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-4181

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018
  • Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237359MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Radiology Associates, Inc Diagnostic Radiology CurrentSince Oct 1, 2008 Accepting new patients
TMC Radiology Cra LLC Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Harbor Medical Associates, Inc. Diagnostic Radiology CurrentSince Jul 1, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2023 Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Jul 1, 2023 Accepting new patients
North Shore Medical Center, Inc. Current Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Umass Memorial Radiology Phys Serv Diagnostic Radiology CurrentSince Dec 1, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology CurrentSince Jul 1, 2023 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Jul 1, 2023 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Feb 12, 2023 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Feb 12, 2023 Accepting new patients

Locations

800 Washington St
#1013
Boston, MA 02111
Phone (617) 636-0491

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

75 Francis St
Boston, MA 02115

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-2063

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

10 Little Brook Rd
West Wareham, MA 02576

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

30 Tuscan Blvd
Salem, NH 03079
Phone (857) 282-8100

Interoperability endpoints

  • Direct secure messaging: makim.shital.nsmc@direct.partners.masshiway.net

Organizations & group practices 12

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1396918496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30, CAMBRIDGEPARK DRIVE",
            "address_2": "APT 8127",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02140",
            "telephone_number": "847-343-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-3850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKIM",
        "first_name": "SHITAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125-05-1880",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "237359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.