Michael Robert Shemkus, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN1858218 Issued in MA

Practice address

270 Quincy Ave
Quincy, MA 02169-8127

Phone

(617) 773-9500

NPI assigned

May 13, 2014

Last updated

Aug 29, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 21, 2020 through Feb 21, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 42 North Dental Oral Surgery of Ma, PLLC

  dba South Shore Oral Surgery Associates

  • Dental Clinic/Center
  • Quincy, MA
  • NPI 1730846403
  NPD
• South Shore Oral Surgery Associates Co. Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Quincy, MA
  • NPI 1053462358
  NPD (past)

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1861803967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NEWHALL ST # 2",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021222312",
            "telephone_number": "857-472-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 QUINCY AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021698127",
            "telephone_number": "617-773-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEMKUS",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1858218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn W. Sheehan, LACD
• William E Sheehan Jr., OD
• Diane Mary Sheehy, OTR
• Caleb Sheldon, LCSW
• Erica Sheldon
• Lei Shen
• Anita Sheppard
• Shelby Sheridan, PA-C
• Amanda Sherman
• Shane Sherman

• Oral and Maxillofacial Surgery (Dentist) in Quincy, MA
• Providers in Quincy, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.