Individual provider Active NPI

Lisa Anne Shaw

  • Psychiatric/Mental Health Nurse Practitioner
  • Milford, MA
National Provider Identifier
1881326403
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2291167 Issued in MA
Practice address
14 Prospect St
Milford, MA 01757-3003
Phone
(508) 902-5923
NPI assigned
Jun 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2291167 MA Primary

Addresses

Primary practice location

14 Prospect St
Milford, MA 01757-3003

Mailing address

71 Fiske Mill Rd
Upton, MA 01568-1207

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220902000153 MA Practitioner - Nurse Practitioner 8426432873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

14 Prospect St
Milford, MA 01757-3003
Phone (508) 473-1190

Hospital & facility affiliations

  • Milford Regional Medical Center Hospital, Milford, MA, CCN 220090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2291167MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Current Accepting new patients
Milford Regional Physician Group, Inc. CurrentSince Aug 29, 2022 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Milford Regional Physician Group, Inc. CurrentSince Aug 29, 2022 Accepting new patients

Locations

9 Industrial Rd
Ste 5
Milford, MA 01757
Phone (508) 473-1480

14 Prospect St
Milford, MA 01757
Phone (508) 422-2343

100 Medway Rd
Ste 401
Milford, MA 01757
Phone (508) 634-7338

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

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.

Hospital & facility affiliations 1

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": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1881326403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 FISKE MILL RD",
            "city": "UPTON",
            "state": "MA",
            "postal_code": "015681207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 PROSPECT ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573003",
            "telephone_number": "508-902-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2291167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

Verify at the official NPI Registry.