Derri Shtasel, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

158370 Issued in MA

Practice address

15 Parkman St, Wac 812
Massachusetts General Hospital
Boston, MA 02114

Phone

(617) 643-4340

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shtasel.derri.mgh@direct.partners.masshiway.net

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.

• General Hospital Corp

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1508390014
  NPD

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1417021684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PARKMAN ST, WAC 812",
            "address_2": "MASSACHUSETTS GENERAL HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021141047",
            "telephone_number": "617-643-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PARKMAN ST, WAC 812",
            "address_2": "MASSACHUSETTS GENERAL HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-643-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHTASEL",
        "first_name": "DERRI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "158370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Shrock, MD
• Stuti Girish Shroff, MD, MBBS
• Sunil Dilipkumar Shroff, MD
• Abbigail Shrontz, MD
• Tara Shrout, MD, MS
• Gerri Feuer Shubow, MS
• Samuel J Shubrooks Jr., M.D.
• Renee Shuder
• Cassandra Shuffain-Tobin, LMHC, ATR
• Taylor Michelle Shugars, CT

• Psychiatry Physician in Boston, MA
• Providers in Boston, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.