Individual provider Active NPI

Jeffrey Alan Shih, M.D.

  • Cardiovascular Disease Physician
  • Worcester, MA
National Provider Identifier
1487832242
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
240448 Issued in MA
Practice address
55 Lake Avenue North
Worcester, MA 01655
Phone
(508) 856-3452
NPI assigned
Feb 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 240448 MA
Cardiovascular Disease Physician 207RC0000X 240448 MA Primary

Addresses

Primary practice location

55 Lake Avenue North
Worcester, MA 01655

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other identifiers 1

IdentifierTypeStateIssuer
110082932AMedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jshih11103@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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
I20090917000100 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Advanced Heart Failure and Transplant Cardiology 3375699333 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Advanced Heart Failure and Transplant Cardiology
Education
Emory University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001
  • Umass Memorial Health - Harrington Hospital Hospital, Southbridge, MA, CCN 220019
  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176
  • 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
240448MAMDAdvanced Heart Failure and Transplant Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Jul 31, 2009 Accepting new patients
Cardiovascular Center at Tufts Medical Center, Inc. Cardiovascular Disease CurrentSince Aug 1, 2018 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jul 31, 2009 Accepting new patients
Reliant Medical Group, Inc Advanced Heart Failure and Transplant Cardiology CurrentSince Apr 4, 2022 Accepting new patients
Umass Memorial Medical Center, Inc. Past Accepting new patients

Locations

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

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Interoperability endpoints

  • Direct secure messaging: jeffrey.shih.npi1487832242.reliant@direct.optumcare.masshiway.net
  • Direct secure messaging: jshih11103@umassmemorial.direct-ci.com

Organizations & group practices 5

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 6

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": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1487832242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVENUE NORTH",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01655",
            "telephone_number": "508-856-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIH",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-04",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "MA",
            "license": "240448",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "240448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110082932A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshih11103@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Avenue North",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "01655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Avenue North",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "01655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.