Individual provider Active NPI

Samuel Shaw-Wilgoski, PMHNP

  • Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
  • Framingham, MA
National Provider Identifier
1629834452
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Family Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0810X
License
RN2324798 Issued in MA
Practice address
1881 Worcester Rd Ste 203
Framingham, MA 01701-5410
Phone
(860) 335-2418
Fax
(508) 532-1168
NPI assigned
Feb 28, 2024
Last updated
Sep 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist 364SP0810X RN2324798 MA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN2324798 MA

Addresses

Primary practice location

1881 Worcester Rd Ste 203
Framingham, MA 01701-5410

Mailing address

1881 Worcester Rd Ste 203
Framingham, MA 01701-5410
Phone (508) 834-3183

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
I20241007003328 MA Practitioner - Nurse Practitioner 2860923455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Therapeutics LLCGroup PAC ID 9638234750, 13 clinicians

Practice addresses (Care Compare)

1881 Worcester Rd
Suite 203
Framingham, MA 01701-5410
Phone (508) 834-3183

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2324798MAMDChild & Family Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Therapeutics LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

1881 Worcester Rd
Ste 203
Framingham, MA 01701
Phone (508) 834-3183

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, 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": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1629834452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 WORCESTER RD STE 203",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017015410",
            "telephone_number": "508-834-3183",
            "fax_number": "508-532-1168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 WORCESTER RD STE 203",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017015410",
            "telephone_number": "860-335-2418",
            "fax_number": "508-532-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW-WILGOSKI",
        "first_name": "SAMUEL",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-28",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0810X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family",
            "state": "MA",
            "license": "RN2324798",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2324798",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

Verify at the official NPI Registry.