Active NPI
Shayna Christine Diedrich-Pugh, ACNP
- Gerontology Nurse Practitioner
- Portland, ME
National Provider Identifier
1700650777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- CNP251857
- Practice address
- 930 Congress St
Portland, ME 04102-3032 - Phone
- (207) 662-1535
- Fax
- (207) 761-3021
- NPI assigned
- Nov 10, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | CNP251857 | ME | Primary |
| Acute Care Nurse Practitioner | 363LA2100X | CNP251857 | ME | |
| Nurse Practitioner | 363L00000X | RN2314195 | MA |
Addresses
Primary practice location
930 Congress St
Portland, ME 04102-3032
Mailing address
930 Congress St
Portland, ME 04102-3032
Phone (207) 662-1535
Other practice location 1
55 Lake Ave N
Worcester, MA 01655-0001
Phone (508) 334-8515
Other practice location 2
119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-8515
Other names 1
- Shayna Diedrich
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-1000
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
930 Congress St
Portland, ME 04102-3032
Phone (207) 662-4535
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2314195 | MA | MD | Nurse Practitioner |
| CNP251857 | ME | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Group, Inc. | Current | Accepting new patients | |
| Umass Memorial Medical Group Inc | Nurse Practitioner | Current | Accepting new patients |
| Mainehealth | Past | Accepting new patients |
Locations
119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
Nurse Practitioner
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Urgent Care Clinic/Center
- Oxford, MA
- NPI 1982381018
-
- Family Medicine Physician
- Portland, ME
- NPI 1629761978
Hospital & facility affiliations 37
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772409600000",
"number": "1700650777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 CONGRESS ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023032",
"telephone_number": "207-662-1535",
"fax_number": "207-761-3021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 CONGRESS ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023032",
"telephone_number": "207-662-1535",
"fax_number": "207-761-3021"
}
],
"practiceLocations": [
{
"address_1": "55 Lake Ave N",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016550001",
"country_code": "US",
"telephone_number": "508-334-8515",
"fax_number": "508-334-6490",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "119 Belmont St",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016052903",
"country_code": "US",
"telephone_number": "508-334-8515",
"fax_number": "508-334-6490",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIEDRICH-PUGH",
"first_name": "SHAYNA",
"middle_name": "CHRISTINE",
"credential": "ACNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-10",
"last_updated": "2026-03-02",
"certification_date": "2026-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "ME",
"license": "CNP251857",
"primary": true
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "ME",
"license": "CNP251857",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "RN2314195",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHAYNA",
"last_name": "DIEDRICH",
"credential": "NP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; 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.