Individual provider Active NPI

Stephanie L Shapiro, M.D.

  • Internal Medicine Physician
  • Cambridge, MA
National Provider Identifier
1487693487
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
159923 Issued in MA
Practice address
77 Massachusetts Avenue
E-23 2 East
Cambridge, MA 01239-4307
Phone
(617) 253-0883
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 159923 MA Primary

Addresses

Primary practice location

77 Massachusetts Avenue
E-23 2 East
Cambridge, MA 01239-4307

Mailing address

77 Massachusetts Avenue
E-23 2 East
Cambridge, MA 01239-4307
Phone (617) 253-0883

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070524000377 MA Practitioner - Internal Medicine 9830296912 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
159923MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Institute of Technology CurrentSince May 1, 2007 Accepting new patients

Locations

25 Carleton St
#E23
Cambridge, MA 02142
Phone (617) 253-0556

77 Massachusetts Ave
#E23308
Cambridge, MA 02139
Phone (617) 258-5332

25 Carleton St
Cambridge, MA 02142
Phone (617) 253-0556

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1487693487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 MASSACHUSETTS AVENUE",
            "address_2": "E-23 2 EAST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "012394307",
            "telephone_number": "617-253-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MASSACHUSETTS AVENUE",
            "address_2": "E-23 2 EAST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "012394307",
            "telephone_number": "617-253-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "159923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.