Shirley Pak So, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

249041 Issued in MA

Practice address

291 Lincoln St
Worcester, MA 01605-3643

Phone

(508) 334-6251

Fax

(508) 334-6906

NPI assigned

Jun 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Geriatric MedicineAlso: Internal Medicine

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Notre Dame Hospice Hospice, Worcester, MA, CCN 221575
• Notre Dame Long Term Care Center Nursing home, Worcester, MA, CCN 225577
• Shrewsbury Rehabilitation and Nursing at Southgate Nursing home, Shrewsbury, MA, CCN 225491

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

82.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sso274077@umassmemorial.direct-ci.com

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.

• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373
  Medicare reassignment Care Compare group NPD
• Umass Memorial Medical Group, Inc.

  • Urgent Care Clinic/Center
  • Oxford, MA
  • NPI 1982381018
  NPD
• Notre Dame Health Care Center,Inc

  • Skilled Nursing Facility
  • Worcester, MA
  • NPI 1396736930
  NPD (past)
• Shrewsbury SNF Operations LLC

  • Skilled Nursing Facility
  • Shrewsbury, MA
  • NPI 1619734456
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Notre Dame Health Care Center, Inc.

  • Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
  • Worcester, MA
  • NPI 1689703068
  Care Compare affiliation
• Notre Dame Health Care Center,Inc

  • Skilled Nursing Facility
  • Worcester, MA
  • NPI 1396736930

  Nursing home

  Care Compare affiliation
• Shrewsbury SNF Operations LLC

  • Skilled Nursing Facility
  • Shrewsbury, MA
  • NPI 1619734456

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651363200000",
    "number": "1639466592",
    "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",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053643",
            "telephone_number": "508-334-6251",
            "fax_number": "508-334-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "SHIRLEY",
        "middle_name": "PAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2022-05-01",
        "certification_date": "2022-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "249041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sso274077@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "119 Belmont St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052903",
            "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": "119 Belmont St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brianna Snow
• Jeanne Marie Snow, ANP-BC
• Lydia Snowie
• Donovan Snyder
• Louis M. Snyder, MD
• Brianna Susan Soares
• Katelyn D Soares, MD
• Samara Sober
• Ahmed M. Sobieh, MD
• Thomas Sobolewski, R.D.O.

• Geriatric Medicine (Internal Medicine) Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.