Individual provider Active NPI

Shivali Poonit Marketkar, MD

  • Anatomic Pathology Physician
  • Boston, MA
National Provider Identifier
1740627884
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
27089 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5400
Phone
(617) 667-7120
Fax
(617) 667-7284
NPI assigned
May 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 27089 MA Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD16167 RI

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5400

Mailing address

115 Lincoln St
Framingham, MA 01702-6358
Phone (617) 667-7284

Other practice location 1

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7000

Other practice location 2

101 Dudley St
Providence, RI 02905-2401
Phone (401) 453-7655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180503000292 RI Practitioner - Pathology 9638396187 Reassigns benefits to 2 organizations
I20180911001513 MA Practitioner - Pathology 9638396187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

101 Dudley St
Providence, RI 02905-2401
Phone (401) 274-1122

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

455 Tollgate Rd
Warwick, RI 02886-2759

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27089MAMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Women & Infants Hospital of Rhode Island CurrentSince Oct 1, 2021 Accepting new patients
Affinity Physicians LLC CurrentSince Oct 1, 2025 Accepting new patients
Kent County Memorial Hospital CurrentSince Oct 1, 2021 Accepting new patients
Metrowest Pathology Associates Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2018 Accepting new patients
Kent County Memorial Hospital CurrentSince Oct 1, 2021 Accepting new patients
Affinity Physicians LLC. Anatomic Pathology Current Accepting new patients
Gbgastro LLC CurrentSince Jan 20, 2019 Accepting new patients
University Gastroenterology, LLC CurrentSince May 1, 2018 Accepting new patients

Locations

475 Franklin St
Ste 110
Framingham, MA 01702
Phone (508) 620-9200

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

33 Staniford St
Providence, RI 02905
Phone (401) 274-1810

33 Staniford St
#2
Providence, RI 02905

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

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 4

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": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1740627884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LINCOLN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017026358",
            "telephone_number": "617-667-7284",
            "fax_number": "617-667-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-7120",
            "fax_number": "617-667-7284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7000",
            "fax_number": "401-736-4546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-453-7655",
            "fax_number": "401-276-7828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKETKAR",
        "first_name": "SHIVALI",
        "middle_name": "POONIT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MA",
            "license": "27089",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "RI",
            "license": "MD16167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.