NPIMap

Individual provider Active NPI

Christopher W Shanahan, M.D., M.P.H.

  • Internal Medicine Physician
  • Mattapan, MA
National Provider Identifier
1730184854
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
74099 Issued in MA
Practice address
1575 Blue Hill Ave
Mattapan, MA 02126-2122
Phone
(617) 829-6006
Fax
(617) 296-5408
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X 74099 MA
Internal Medicine Physician 207R00000X 74099 MA Primary

Addresses

Primary practice location

1575 Blue Hill Ave
Mattapan, MA 02126-2122

Mailing address

801 Albany St FL G
Boston, MA 02119-3791

Other practice location 1

801 Massachusetts Ave
2nd FL
Boston, MA 02118-2526
Phone (617) 414-7399

Other identifiers 1

IdentifierTypeStateIssuer
110050376AMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050415000567 MA Practitioner - Internal MedicinePractitioner - Addiction Medicine 6901843499 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine
Education
Rutgers New Jersey Medical School, 1988
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Savida Health PCGroup PAC ID 4082809967, 89 clinicians

Practice addresses (Care Compare)

1575 Blue Hill Ave
Boston, MA 02126-2122
Phone (617) 296-0061

50 Union St
West Springfield, MA 01089-3317
Phone (413) 732-0040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74099MAMDAddiction Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Medical Foundation, Inc. Internal Medicine CurrentSince Jan 17, 2009 Accepting new patients
Savida Health, PC Current Accepting new patients
Savida Health, PC CurrentSince Mar 13, 2025 Accepting new patients
Savida Health, PC CurrentSince Mar 13, 2025 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Mattapan Community Health Center Inc CurrentSince Feb 17, 2020 Accepting new patients
Mattapan Community Health Center Inc Past Accepting new patients

Locations

725 Albany St
Ste B
Boston, MA 02118
Phone (617) 638-7480

88 East Newton St
#H2
Boston, MA 02118
Phone (617) 638-8776

801 Massachusetts Ave
Fl 2
Boston, MA 02118
Phone (617) 414-4376

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

12 Dallaire Ave
Chicopee, MA 01020
Phone (413) 333-5608

1575 Blue Hill Ave
Mattapan, MA 02126
Phone (617) 296-0061

77 Hospital Ave
Ste 104
North Adams, MA 01247
Phone (413) 398-5180

801 Albany St
Fl G
Roxbury, MA 02119

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

80 Congress St
Ste 104
Springfield, MA 01104
Phone (413) 732-0040

50 Union St
West Springfield, MA 01089
Phone (413) 732-0040

Interoperability endpoints

  • Direct secure messaging: christopher.shanahan.1@24804.direct.athenahealth.com
  • Direct secure messaging: cshanahan12048@direct.bmc.masshiway.net
  • Direct secure messaging: cshanahan164681@direct.ochin.org

Organizations & group practices 7

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1730184854",
    "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": "1575 BLUE HILL AVE",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262122",
            "telephone_number": "617-829-6006",
            "fax_number": "617-296-5408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Massachusetts Ave",
            "address_2": "2nd FL",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182526",
            "country_code": "US",
            "telephone_number": "617-414-7399",
            "fax_number": "617-414-4676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "W",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "MA",
            "license": "74099",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "74099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110050376A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattapan, MA

Sources for this page

Verify at the official NPI Registry.