Individual provider Active NPI

Jeffrey S Shenberger, MD

  • Neonatal-Perinatal Medicine Physician
  • Springfield, MA
National Provider Identifier
1629020110
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
073331 Issued in CT
Practice address
759 Chestnut St
Springfield, MA 01199-1619
Phone
(413) 794-5370
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 253811 MA
Neonatal-Perinatal Medicine Physician 2080N0001X 073331 CT Primary

Addresses

Primary practice location

759 Chestnut St
Springfield, MA 01199-1619

Mailing address

280 Chestnut St
2ND Floor
Springfield, MA 01199-1619
Phone (413) 794-5700

Other practice location 1

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-8950

Other identifiers 1

IdentifierTypeStateIssuer
073331OtherCTLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JSHENBERGER83444@CONNECTICUTCHILDRENS.DIRECT-CI.COM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190124001631 NC Practitioner - Pediatric Medicine 2668496415
I20230223001091 CT Practitioner - Pediatric Medicine 2668496415 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
073331CTMDNeonatal-Perinatal Medicine Physician
253811MAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children's Specialty Group, Inc. Neonatal-Perinatal Medicine CurrentSince Feb 15, 2023 Accepting new patients
Connecticut Children's Specialty Group, Inc. Neonatal-Perinatal Medicine CurrentSince Feb 15, 2023 Accepting new patients

Locations

10 Columbus Blvd
Fl 4
Hartford, CT 06106
Phone (860) 837-5560

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

Interoperability endpoints

  • Direct secure messaging: jshenberger83444@connecticutchildrens.direct-ci.com

Organizations & group practices 2

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1629020110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991619",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 CHESTNUT ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991619",
            "telephone_number": "413-794-5370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-545-8950",
            "fax_number": "860-545-8959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHENBERGER",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MA",
            "license": "253811",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CT",
            "license": "073331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "073331",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JSHENBERGER83444@CONNECTICUTCHILDRENS.DIRECT-CI.COM",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.