Individual provider Active NPI

Shahrzad Tavana, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1750948014
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1017915 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 724-0223
NPI assigned
May 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 1017915 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

5323 Harry Hines Blvd # Mc9159
Dallas, TX 75390-7208
Phone (713) 474-6286

Other practice location 1

5323 Harry Hines Blvd # Mc9159
Dallas, TX 75390-7208
Phone (713) 474-6286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 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
I20240709000276 MA Practitioner - Diagnostic Radiology 0143647339 Reassigns benefits to 3 organizations
I20250528000795 NH Practitioner - Diagnostic Radiology 0143647339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Southwestern Medical School at Dallas, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Boston, MA 02114-2181
Phone (617) 643-0003

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 354-4181

102 Endicott St
Danvers, MA 01923-3623
Phone (978) 354-4181

15 Corporate Park Dr
Pembroke, MA 02359-1966
Phone (781) 826-8065

170 Governors Ave
Medford, MA 02155-1643
Phone (781) 395-4909

200 Route 108
Somersworth, NH 03878-1119
Phone (603) 740-2250

30 Locust St
Northampton, MA 01060-2052
Phone (978) 354-4181

30 Tuscan Blvd
Salem, NH 03079-3981
Phone (857) 282-8100

4 Centennial Dr
Peabody, MA 01960-7935
Phone (978) 354-4181

480 Lynnfield St
Lynn, MA 01904-1419
Phone (781) 342-4386

65 Calef Hwy
Lee, NH 03861-6703
Phone (603) 740-2250

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-4181

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Jul 1, 2025 Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2024 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

62 13th St
Charlestown, MA 02129
Phone (617) 724-4260

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-2063

30 Tuscan Blvd
Salem, NH 03079
Phone (857) 282-8100

Interoperability endpoints

  • Direct secure messaging: tavana.shahrzad.mgh@direct.partners.masshiway.net

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.

Hospital & facility affiliations 7

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": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1750948014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD # MC9159",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907208",
            "telephone_number": "713-474-6286"
        },
        {
            "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": "617-724-0223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd # Mc9159",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753907208",
            "country_code": "US",
            "telephone_number": "713-474-6286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAVANA",
        "first_name": "SHAHRZAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "1017915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.