NPIMap

Organization Active NPI

Boston Sports & Shoulder Center, LLC

Doing business as Boston Sports & Shoulder Center

  • Orthopaedic Surgery Physician
  • Westborough, MA
National Provider Identifier
1770975823
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BOSTON SPORTS & SHOULDER CENTER, LLC
Doing business as
Boston Sports & Shoulder Center
Practice address
150 Flanders Rd
Westborough, MA 01581-1017
Phone
(781) 890-2133
Fax
(781) 890-2177
NPI assigned
Feb 26, 2015
Last updated
Mar 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Mr. Jonathan Shaker
Title
Executive Directive
Phone
(781) 890-2133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

150 Flanders Rd
Westborough, MA 01581-1017

Mailing address

840 Winter St
Attn: Boston Sports & Shoulder Center
Waltham, MA 02451-1433
Phone (781) 890-2133

Other names 1

  • Boston Sports & Shoulder Center Doing business as

National Provider Directory

National Provider Directory

Locations

123 Waterhouse Rd
Bourne, MA 02532
Phone (508) 759-7920

40 Allied Dr
#102
Dedham, MA 02026
Phone (617) 264-1100

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1770975823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 WINTER ST",
            "address_2": "ATTN: BOSTON SPORTS & SHOULDER CENTER",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511433",
            "telephone_number": "781-890-2133",
            "fax_number": "781-890-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 FLANDERS RD",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015811017",
            "telephone_number": "781-890-2133",
            "fax_number": "781-890-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON SPORTS & SHOULDER CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "SHAKER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTIVE",
        "authorized_official_telephone_number": "781-890-2133",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boston Sports & Shoulder Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.