NPIMap

Individual provider Active NPI

Shan Qin, M.D., PH.D.

  • Nephrology Physician
  • Dartmouth, MA
National Provider Identifier
1891138822
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
274975 Issued in MA
Practice address
537 Faunce Corner Rd
Dartmouth, MA 02747
Phone
(508) 996-3991
NPI assigned
Apr 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 274975 MA
Nephrology Physician 207RN0300X 274975 MA Primary

Addresses

Primary practice location

537 Faunce Corner Rd
Dartmouth, MA 02747

Mailing address

537 Faunce Corner Rd
Dartmouth, MA 02747-1242
Phone (508) 996-3991

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
I20180821003581 MA Practitioner - Internal MedicinePractitioner - Nephrology 7113212234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group of Massachusetts IncGroup PAC ID 3870020399, 458 clinicians

Practice addresses (Care Compare)

2007 Bay St
Taunton, MA 02780-1086

531 Faunce Corner Rd
Dartmouth, MA 02747-1242
Phone (508) 996-3991

535 Faunce Corner Rd
Dartmouth, MA 02747-1242
Phone (508) 996-3991

537 Faunce Corner Rd
Dartmouth, MA 02747-1242
Phone (508) 996-3991

795 Middle St
Fall River, MA 02721-1733
Phone (508) 674-5600

Hospital & facility affiliations

  • Hawthorn Kidney Center Dialysis facility, Dartmouth, MA, CCN 222503
  • Community Nurse Home Care Home health agency, Fairhaven, MA, CCN 227027
  • Southcoast Visiting Nurse Association Inc Home health agency, Fairhaven, MA, CCN 227101
  • Amedisys Home Health Care Home health agency, Wakefield, MA, CCN 227211
  • Saint Anne'S Hospital Hospital, Fall River, MA, CCN 220020
  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074
  • Vibra Hospital of Southeastern Massachusetts Long-term care hospital, New Bedford, MA, CCN 222043

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Corporation Current Accepting new patients
Steward Medical Group, Inc Internal Medicine CurrentSince Sep 4, 2018 Accepting new patients
Lifespan Physician Group of Massachusetts Inc Internal Medicine CurrentSince Jan 1, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Sep 4, 2018 Accepting new patients

Locations

851 Middle St
Ste 2100
Fall River, MA 02721
Phone (508) 235-5445

535 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 961-0665

537 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 672-0545

531 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 991-2255

Interoperability endpoints

  • Direct secure messaging: sqin236111@brownhealth.medalliesdirect.net
  • Direct secure messaging: shan.qin.1@2017.direct.athenahealth.com

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 7

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1891138822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 FAUNCE CORNER RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471242",
            "telephone_number": "508-996-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 FAUNCE CORNER RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "02747",
            "telephone_number": "508-996-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIN",
        "first_name": "SHAN",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "274975",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "274975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dartmouth, MA

Sources for this page

Verify at the official NPI Registry.