Individual provider Active NPI

Robert Shertick, NP

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1528606035
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2273304 Issued in MA
Practice address
366 Shrewsbury St
Worcester, MA 01604-4647
Phone
(508) 595-2700
Fax
(774) 221-5136
NPI assigned
Dec 16, 2019
Last updated
Dec 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2273304 MA Primary

Addresses

Primary practice location

366 Shrewsbury St
Worcester, MA 01604-4647

Mailing address

366 Shrewsbury St
Worcester, MA 01604-4647
Phone (508) 595-2700

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200203002296 MA Practitioner - Nurse Practitioner 9234565631 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

460 Southbridge St
Auburn, MA 01501-2442
Phone (508) 595-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Wound Care Massachusetts PLLC CurrentSince Nov 1, 2022 Accepting new patients
Reliant Medical Group, Inc CurrentSince Feb 17, 2020 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

460 Southbridge St
Auburn, MA 01501
Phone (508) 595-2700

366 Shrewsbury St
Worcester, MA 01604
Phone (508) 595-2700

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

492C Cedar Ln
Teaneck, NJ 07666
Phone (201) 357-5468

Interoperability endpoints

  • Direct secure messaging: robert.shertickjr.npi1528606035.reliant@direct.optumcare.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1528606035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 SHREWSBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044647",
            "telephone_number": "508-595-2700",
            "fax_number": "774-221-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 SHREWSBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044647",
            "telephone_number": "508-595-2700",
            "fax_number": "774-221-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERTICK",
        "first_name": "ROBERT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2273304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.