Active NPI
Martin J Shelly, MB BCH
- Diagnostic Radiology Physician
- Boston, MA
National Provider Identifier
1881983203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- L-246693
- Practice address
- 55 Fruit St.
Massachusetts General Hospital
Boston, MA 02114 - Phone
- (617) 726-8386
- NPI assigned
- Apr 6, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | L-246693 | MA | Primary |
Addresses
Primary practice location
55 Fruit St.
Massachusetts General Hospital
Boston, MA 02114
Mailing address
55 Fruit St.
Massachusetts General Hospital
Boston, MA 02114
Phone (617) 726-8386
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L-246693 | MA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302048000000",
"number": "1881983203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 FRUIT ST.",
"address_2": "MASSACHUSETTS GENERAL HOSPITAL",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-726-8386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST.",
"address_2": "MASSACHUSETTS GENERAL HOSPITAL",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-726-8386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLY",
"first_name": "MARTIN",
"middle_name": "J",
"credential": "MB BCH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-06",
"last_updated": "2011-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "L-246693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.