Individual provider Active NPI

Edward Shashoua, D.O.

  • Internal Medicine Physician
  • Cambridge, MA
National Provider Identifier
1811916802
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
217054 Issued in MA
Practice address
2500 Massachusetts Ave
Cambridge, MA 02140-1628
Phone
(617) 661-6225
Fax
(617) 492-2002
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 217054 MA Primary

Addresses

Primary practice location

2500 Massachusetts Ave
Cambridge, MA 02140-1628

Mailing address

2500 Massachusetts Ave
Cambridge, MA 02140-1628
Phone (617) 661-6225

Other identifiers 1

IdentifierTypeStateIssuer
2020351MedicaidMA

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
I20060812000006 MA Practitioner - Internal MedicinePractitioner - Vascular Surgery 1759384779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Vascular Surgery
Education
University of New England, College of Osteo Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

125 Oakland St
Wellesley, MA 02481-5338
Phone (781) 237-2161

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • Beth Israel Deaconess Hospital - Needham Hospital, Needham, MA, CCN 220083
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of Boston Management Corporation Internal Medicine CurrentSince Dec 23, 2018 Accepting new patients
Marino Foundation for Integrative Medicine, Inc. Internal Medicine Past Accepting new patients

Locations

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

125 Oakland St
Wellesley Hills, MA 02481
Phone (781) 237-2161

372 Washington St
Wellesley Hls, MA 02481
Phone (781) 235-5200

Interoperability endpoints

  • Direct secure messaging: eshashoua447848@direct.bilh.masshiway.net

Organizations & group practices 2

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 3

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1811916802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021401628",
            "telephone_number": "617-661-6225",
            "fax_number": "617-492-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021401628",
            "telephone_number": "617-661-6225",
            "fax_number": "617-492-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHASHOUA",
        "first_name": "EDWARD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "217054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2020351",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.