Individual provider Active NPI

Theresa L Shanahan, MD

  • Pediatrics Physician
  • Dedham, MA
National Provider Identifier
1780681627
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
206175 Issued in MA
Practice address
1 Lyons St
Dedham, MA 02026-5599
Phone
(781) 329-1400
Fax
(781) 278-5667
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 206175 MA Primary

Addresses

Primary practice location

1 Lyons St
Dedham, MA 02026-5599

Mailing address

PO Box 9120
Dedham, MA 02027-9120
Phone (781) 329-1400

Other identifiers 16

IdentifierTypeStateIssuer
1240820OtherUNITED HEALTHCARE
204130OtherHARVARD PILGRIM PPO
0023152OtherNEIGHBORHOOD HEALTH
206175OtherTUFTS
0141330OtherMASS HEALTH
204130OtherFIRST SENIORITY
204130OtherHARVARD PILGRIM POS
206175OtherTUFTS COMMONWEALTH PPO
27697OtherCHILDREN'S MED SECURITY
J23933OtherHMO BLUE/BLUE CHOICE
204130OtherHARVARD PILGRIM
2780341OtherMAHEALTHSOURCE
J23933OtherBS-BLUE CARE ELECT
206175OtherTUFTS TOTAL HEALTH PLAN
2780341OtherCIGNA HEALTH CARE
J23933OtherBLUE SHIELD INDEMNITYY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
206175MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newton Wellesley Hospital Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shanahan.theresa.nwh@direct.partners.masshiway.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780681627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9120",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020279120",
            "telephone_number": "781-329-1400",
            "fax_number": "781-278-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LYONS ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020265599",
            "telephone_number": "781-329-1400",
            "fax_number": "781-278-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "THERESA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "206175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1240820",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM PPO",
            "identifier": "204130",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0023152",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "206175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS HEALTH",
            "identifier": "0141330",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST SENIORITY",
            "identifier": "204130",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM POS",
            "identifier": "204130",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS COMMONWEALTH PPO",
            "identifier": "206175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDREN'S MED SECURITY",
            "identifier": "27697",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE/BLUE CHOICE",
            "identifier": "J23933",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "204130",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "2780341",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS-BLUE CARE ELECT",
            "identifier": "J23933",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS TOTAL HEALTH PLAN",
            "identifier": "206175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH CARE",
            "identifier": "2780341",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNITYY",
            "identifier": "J23933",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.