Shameen S. Wijesundara, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

273942 Issued in MA

Practice address

119 Belmont St
Worcester, MA 01605-2903

Phone

(508) 334-8515

Fax

(508) 334-6490

NPI assigned

Apr 17, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MA

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 1

Specialty

Internal Medicine

Education

Boston University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marlborough Hospitalist Group PLLCGroup PAC ID 1254793888, 27 clinicians

Henry Heywood Memorial HospitalGroup PAC ID 1658262605, 116 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Heywood Hospital - Hospital, Gardner, MA, CCN 220095
• Marlborough Hospital Hospital, Marlborough, MA, CCN 220049

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

82.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swijesunda8163@umassmemorial.direct-ci.com

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.

• Henry Heywood Memorial Hospital

  • General Acute Care Hospital
  • Gardner, MA
  • NPI 1205823879

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Marlborough Hospitalist Group, PLLC

  • Hospitalist Physician
  • Marlborough, MA
  • NPI 1316639321
  Medicare reassignment Care Compare group NPD
• Athol Memorial Hospital Incorporated

  • Critical Access Hospital
  • Athol, MA
  • NPI 1336120047

  Family Medicine

  Medicare reassignment NPD
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373

  Family Medicine

  Medicare reassignment NPD
• Henry Heywood Memorial Hospital

  • Psychiatric Hospital Unit
  • Gardner, MA
  • NPI 1457685299
  NPD
• Umass Memorial Medical Group, Inc.

  • Urgent Care Clinic/Center
  • Oxford, MA
  • NPI 1982381018
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marlborough Hospital Corp

  • Registered Dietitian
  • Marlborough, MA
  • NPI 1104488170

  Hospital

  Care Compare affiliation Name & address match
• Henry Heywood Memorial Hospital

  • General Acute Care Hospital
  • Gardner, MA
  • NPI 1205823879
  Care Compare affiliation
• Heywood Medical Group Inc.

  • General Practice Physician
  • Gardner, MA
  • NPI 1699762286

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1801283759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052903",
            "telephone_number": "508-334-8515",
            "fax_number": "508-334-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIJESUNDARA",
        "first_name": "SHAMEEN",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-17",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "273942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swijesunda8163@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "119 Belmont St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "119 Belmont St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amelia Wietman
• Lianna Wiggall
• Shawn Wiggins
• Ashley Jermaine Wight, RD
• Judith Wightman McQuade, PH.D.
• Christopher Wilbert, M.D.
• Ashley Jordan Wilbur
• Holly Ann Wilbur
• Emily Wilcox, PSYD
• Heather Cecile Wilcox

• Family Medicine Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.