Individual provider Active NPI

Michael H O'Shea, MD

  • Nephrology Physician
  • Keene, NH
National Provider Identifier
1831189927
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
20097 Issued in NH
Practice address
590 Court St
Keene, NH 03431
Phone
(603) 653-3830
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hypertension Specialist Physician 207RH0005X 77348 MA
Nephrology Physician 207RN0300X 035409 CT
Nephrology Physician 207RN0300X 77348 MA
Nephrology Physician 207RN0300X 20097 NH Primary

Addresses

Primary practice location

590 Court St
Keene, NH 03431

Mailing address

590 Court St
Keene, NH 03431-1719

Other practice location 1

2150 Main St
Springfield, MA 01104-3566
Phone (413) 733-0010

Other practice location 2

2150 Main St
Springfield, MA 01104-3566
Phone (413) 733-0010

Other identifiers 2

IdentifierTypeStateIssuer
3106624MedicaidMA
003089168MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050525001174 MA Practitioner - Nephrology 6901899442 Reassigns benefits to 1 organization
I20120221000657 CT Practitioner - Nephrology 6901899442 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035409CTMDNephrology Physician
77348MAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jul 9, 2018 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jul 9, 2018 Accepting new patients
Baystate Medical Practices, Inc Past Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

201 Chestnut Hill Rd
Stafford Springs, CT 06076
Phone (860) 265-6521

1000 Asylum Ave
Ste 4302
West Hartford, CT 06105
Phone (860) 714-4270

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Organizations & group practices 4

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1831189927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "03431",
            "telephone_number": "603-653-3830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Main St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011043566",
            "country_code": "US",
            "telephone_number": "413-733-0010",
            "fax_number": "413-930-2108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2150 Main St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011043566",
            "country_code": "US",
            "telephone_number": "413-733-0010",
            "fax_number": "413-930-2108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'SHEA",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0005X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hypertension Specialist",
            "state": "MA",
            "license": "77348",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CT",
            "license": "035409",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "77348",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NH",
            "license": "20097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3106624",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003089168",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.