Individual provider Active NPI

Shan Marie Stoffolano, M.S., C.P.N.P.

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1669692661
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
235651-NP Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(781) 674-2900
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 235651-NP MA Primary
Pediatric Nurse Practitioner 363LP0200X 235651-NP MA

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

62 Park St
Pepperell, MA 01463-1117
Phone (978) 433-0590

Other practice location 1

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

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
I20151229001015 MA Practitioner - Nurse Practitioner 6406157957 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
235651-NPMAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Nurse Practitioner CurrentSince Jun 1, 2021 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jan 1, 2026 Accepting new patients
The General Hospital Corporation CurrentSince Jan 1, 2026 Accepting new patients
Patriot Pediatrics Current Accepting new patients
Atrius Health, Inc. Nurse Practitioner CurrentSince Jun 1, 2021 Accepting new patients

Locations

74 Loomis St
Bedford, MA 01730
Phone (781) 674-2900

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

Interoperability endpoints

  • Direct secure messaging: sstoffolanonp331879@direct.atrius.masshiway.net
  • Direct secure messaging: stoffolano.shan.patpedi@direct.partners.masshiway.net

Organizations & group practices 5

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1669692661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 PARK ST",
            "city": "PEPPERELL",
            "state": "MA",
            "postal_code": "014631117",
            "telephone_number": "978-433-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "781-674-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022153904",
            "country_code": "US",
            "telephone_number": "617-421-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOFFOLANO",
        "first_name": "SHAN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.S., C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "235651-NP",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "235651-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.