Individual provider Active NPI

Shibani Sharon Mukerji, M.D., PH.D.

  • Neurology Physician
  • Boston, MA
National Provider Identifier
1497075964
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
254646 Issued in MA
Practice address
55 Fruit St. Wang Building 7TH Floor
Department of Neruology Massachusetts General Hospital
Boston, MA 02114
Phone
(617) 726-8639
Fax
(617) 724-0895
NPI assigned
Jun 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L-244603 MA
Neurology Physician 2084N0400X 254646 MA Primary

Addresses

Primary practice location

55 Fruit St. Wang Building 7TH Floor
Department of Neruology Massachusetts General Hospital
Boston, MA 02114

Mailing address

55 Fruit St
MGH Wang Acc 835
Boston, MA 02114

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
I20150611002532 MA Practitioner - Neurology 9931360070 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L-244603MAMDInternal Medicine Physician
254646MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2015 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
#835
Boston, MA 02114
Phone (617) 726-5532

55 Fruit St
Bldg 7TH
Boston, MA 02114
Phone (617) 726-8548

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

Interoperability endpoints

  • Direct secure messaging: mukerji.shibani.mgh@direct.partners.masshiway.net

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.

Hospital & facility affiliations 1

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": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1497075964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "MGH WANG ACC 835",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST. WANG BUILDING 7TH FLOOR",
            "address_2": "DEPARTMENT OF NERUOLOGY MASSACHUSETTS GENERAL HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-8639",
            "fax_number": "617-724-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKERJI",
        "first_name": "SHIBANI",
        "middle_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "L-244603",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "254646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.