NPIMap

Individual provider Active NPI

Anne B. Shain, M.D.

  • Internal Medicine Physician
  • Chicopee, MA
National Provider Identifier
1881657955
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56340 Issued in MA
Practice address
444 Montgomery St
Chicopee, MA 01020-1969
Phone
(413) 594-3111
Fax
(413) 598-7115
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 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 56340 MA Primary

Addresses

Primary practice location

444 Montgomery St
Chicopee, MA 01020-1969

Mailing address

444 Montgomery St
Chicopee, MA 01020-1969
Phone (413) 594-3111

Other identifiers 1

IdentifierTypeStateIssuer
6188001MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050330000194 MA Practitioner - Internal Medicine 5092761379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

444 Montgomery St
Chicopee, MA 01020-1969
Phone (413) 594-3111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56340MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc. Internal Medicine CurrentSince Jun 1, 2016 Accepting new patients
Riverbend Medical Group, Inc CurrentSince Jun 1, 2016 Accepting new patients
Riverbend Medical Group, Inc Past Accepting new patients
Mwa, PC Past Accepting new patients
Mwa,PC Internal Medicine Past Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

444 Montgomery St
Chicopee, MA 01020
Phone (413) 594-3111

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

Interoperability endpoints

  • Direct secure messaging: ashain2389681@direct.trinity-health.org

Organizations & group practices 5

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.

Hospital & facility affiliations 11

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1881657955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MONTGOMERY ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010201969",
            "telephone_number": "413-594-3111",
            "fax_number": "413-598-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 MONTGOMERY ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010201969",
            "telephone_number": "413-594-3111",
            "fax_number": "413-598-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIN",
        "first_name": "ANNE",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "56340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6188001",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicopee, MA

Sources for this page

Verify at the official NPI Registry.