NPIMap

Individual provider Active NPI

Warren P Shepherd Jr., M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1659595148
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
221919 Issued in MA
Practice address
750 Washington St # 299
Boston, MA 02111-1526
Phone
(617) 636-0067
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 221919 MA Primary

Addresses

Primary practice location

750 Washington St # 299
Boston, MA 02111-1526

Mailing address

19 Allston St # 2
Charlestown, MA 02129-1901
Phone (617) 636-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090810000307 MA Practitioner - Diagnostic Radiology 0840343836 Reassigns benefits to 3 organizations
I20221031002407 CT Practitioner - Diagnostic Radiology 0840343836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tufts University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology and Imaging IncGroup PAC ID 9234110479, 58 clinicians

Practice addresses (Care Compare)

113 Elm St
Suite 206
Enfield, CT 06082-3738
Phone (860) 741-2177

759 Chestnut St
Springfield, MA 01107-1619
Phone (413) 827-7400

Hospital & facility affiliations

  • Baystate Noble Hospital Hospital, Westfield, MA, CCN 220065
  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077
  • Baystate Wing Hospital Hospital, Palmer, MA, CCN 220030
  • Baystate Franklin Medical Center Hospital, Greenfield, MA, CCN 220016
  • Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221919MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc CurrentSince May 4, 2024 Accepting new patients
Baystate MRI & Imaging Center, LLC CurrentSince Oct 1, 2022 Accepting new patients
Franklin MRI Center LLC CurrentSince Oct 1, 2022 Accepting new patients
Radiology & Imaging, Inc. Diagnostic Radiology CurrentSince Nov 1, 2022 Accepting new patients
Riverbend Medical Group, Inc. Diagnostic Radiology CurrentSince May 4, 2024 Accepting new patients
Providence Diagnostic Imaging, Inc. Diagnostic Radiology CurrentSince Aug 1, 2015 Accepting new patients
Greater Springfield MRI Limited Partnership CurrentSince Aug 24, 2015 Accepting new patients
X-Ray Associates, Inc Diagnostic Radiology Past Accepting new patients

Locations

113 Elm St
Ste 206
Enfield, CT 06082
Phone (860) 741-2177

759 Chestnut St
Springfield, MA 01107
Phone (413) 794-6297

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Interoperability endpoints

  • Direct secure messaging: wshepherd2410111@direct.trinity-health.org

Organizations & group practices 8

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 7

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659595148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ALLSTON ST # 2",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021291901",
            "telephone_number": "617-636-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WASHINGTON ST # 299",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111526",
            "telephone_number": "617-636-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "WARREN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "221919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.