Individual provider Active NPI

Shivda Pandey, M.D.

  • Cardiovascular Disease Physician
  • Boston, MA
National Provider Identifier
1689824013
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
268136 Issued in MA
Practice address
732 Harrison Ave
Preston, 3Rd Floor
Boston, MA 02118-2371
Phone
(617) 638-7490
Fax
(617) 414-8742
NPI assigned
Sep 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 268136 MA Primary

Addresses

Primary practice location

732 Harrison Ave
Preston, 3Rd Floor
Boston, MA 02118-2371

Mailing address

801 Albany St FL G
Boston, MA 02119-3791

Other identifiers 1

IdentifierTypeStateIssuer
110098090AMedicaidMA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170105001016 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4385876218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8000

72 E Newton St
CR Evans 124
Boston, MA 02118-2308
Phone (617) 638-7253

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Medical Foundation, Inc. Cardiovascular Disease CurrentSince Dec 5, 2016 Accepting new patients
Boston University Medical Center Radiologists, Inc. CurrentSince Dec 5, 2016 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients

Locations

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

732 Harrison Ave
Fl 3
Boston, MA 02118
Phone (617) 638-5350

637 Washington St
Dorchestr Ctr, MA 02124
Phone (617) 822-8211

801 Albany St
Fl G
Roxbury, MA 02119

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: spandey227260@direct.ochin.org
  • Direct secure messaging: spandey8038@direct.bmc.masshiway.net

Organizations & group practices 3

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 8

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": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1689824013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY ST FL G",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021193791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 HARRISON AVE",
            "address_2": "PRESTON, 3RD FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371",
            "telephone_number": "617-638-7490",
            "fax_number": "617-414-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDEY",
        "first_name": "SHIVDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-22",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "268136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110098090A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.