Individual provider Active NPI

John L Sherman, DPM

  • Podiatrist
  • Medford, MA
National Provider Identifier
1467458737
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1652 Issued in MA
Practice address
26 City Hall Mall
Medford, MA 02155-4754
Phone
(781) 306-5255
Fax
(781) 306-5487
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1652 MA Primary

Addresses

Primary practice location

26 City Hall Mall
Medford, MA 02155-4754

Mailing address

147 Milk St
Boston, MA 02109-4806

Other identifiers 1

IdentifierTypeStateIssuer
0310964MedicaidMA

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060413000077 MA Practitioner - Podiatry 3173532595 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1652MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation CurrentSince Mar 29, 2016 Accepting new patients
DRS. Smith & Stewart Podiatrist Past Accepting new patients

Locations

1353 Dorchester Ave
Dorchester, MA 02122
Phone (617) 288-3230

4199 Washington St
Roslindale, MA 02131
Phone (617) 323-4440

Organizations & group practices 3

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1467458737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 MILK ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021094806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CITY HALL MALL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554754",
            "telephone_number": "781-306-5255",
            "fax_number": "781-306-5487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "JOHN",
        "middle_name": "L",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0310964",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.