Individual provider Active NPI

Shiri Nawrocki, MD

  • Dermatology Physician
  • Boston, MA
National Provider Identifier
1811512627
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
1018446 Issued in MA
Practice address
441 Stuart St Ste 404
Boston, MA 02116-5019
Phone
(857) 317-2057
NPI assigned
Jun 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 1018446 MA Primary

Addresses

Primary practice location

441 Stuart St Ste 404
Boston, MA 02116-5019

Mailing address

441 Stuart St Ste 404
Boston, MA 02116-5019
Phone (857) 317-2057

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240718003158 MA Practitioner - Dermatology 3072059740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Institute of Boston PCGroup PAC ID 7315247178, 4 clinicians

Practice addresses (Care Compare)

441 Stuart St
Boston, MA 02116-5019
Phone (857) 317-2057

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions24
Skin biopsy12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1018446MAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Institute of Boston PC Dermatology CurrentSince Sep 1, 2024 Accepting new patients

Locations

441 Stuart St
Ste 404
Boston, MA 02116
Phone (857) 317-2057

185 Dartmouth St
Ste 404
Boston, MA 02116
Phone (857) 317-2057

441 Stuart St
Ste 4
Boston, MA 02116
Phone (617) 266-6020

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": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1811512627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 STUART ST STE 404",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165019",
            "telephone_number": "857-317-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 STUART ST STE 404",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165019",
            "telephone_number": "857-317-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAWROCKI",
        "first_name": "SHIRI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "1018446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.