Shaza Ben Khadra, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

1021492 Issued in MA

Practice address

759 Chestnut Street
D1170
Springfield, MA 01107-1619

Phone

(413) 794-4550

Fax

(413) 794-3195

NPI assigned

May 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

New England Dermatology PCGroup PAC ID 9436113677, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baystate Medical Center Hospital, Springfield, MA, CCN 220077
• Baystate Franklin Medical Center Hospital, Greenfield, MA, CCN 220016
• Baystate Wing Hospital Hospital, Palmer, MA, CCN 220030
• Brattleboro Memorial Hospital Hospital, Brattleboro, VT, CCN 470011
• Baystate Noble Hospital Hospital, Westfield, MA, CCN 220065

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baystate Medical Practices, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Springfield, MA
  • NPI 1548205909

  Anatomic Pathology & Clinical Pathology

  Medicare reassignment Care Compare group NPD
• New England Dermatology, P.C.

  • Dermatology Physician
  • Springfield, MA
  • NPI 1356348098
  Medicare reassignment Care Compare group NPD

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

• Baystate Franklin Medical Center

  • General Acute Care Hospital
  • Greenfield, MA
  • NPI 1508867391
  Care Compare affiliation
• Baystate Medical Center Inc

  dba Baystate Medical Center

  • General Acute Care Hospital
  • Springfield, MA
  • NPI 1487655064
  Care Compare affiliation
• Baystate Medical Center Inc

  dba Baystate Reference Laboratories

  • Clinical Medical Laboratory
  • Springfield, MA
  • NPI 1568488450

  Hospital

  Care Compare affiliation
• Baystate Noble Hospital Corporation

  • General Acute Care Hospital
  • Westfield, MA
  • NPI 1700816048
  Care Compare affiliation
• Baystate Wing Hospital Corporation

  dba Baystate Wing Hospital & Medical Centers

  • General Acute Care Hospital
  • Palmer, MA
  • NPI 1962410233
  Care Compare affiliation
• Brattleboro Memorial Hospital

  • General Acute Care Hospital
  • Brattleboro, VT
  • NPI 1306849708
  Care Compare affiliation

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

{
    "created_epoch": "1590364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1477176444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT STREET",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-3909",
            "fax_number": "413-794-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 CHESTNUT STREET",
            "address_2": "D1170",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071619",
            "telephone_number": "413-794-4550",
            "fax_number": "413-794-3195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-5057",
            "fax_number": "401-606-1233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEN KHADRA",
        "first_name": "SHAZA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-25",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "RI",
            "license": "LP04980",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "1021492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Anne Belliveau
• Myosoti Kyshaelis Bello Irizarry
• Monica Lee Bellucci
• Luis Beltran
• Bemore Wellness, LLC
• Kelly Benabou, MD
• Mark K Benander, PH.D., M.S.
• Tatiana V Bendioukova, MD
• Beneath the Healing LLC
• Amie Benedict

• Anatomic Pathology & Clinical Pathology Physician in Springfield, MA
• Providers in Springfield, MA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.