Suzanne M. Shroba, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

154413 Issued in MA

Practice address

20 Patriot PL
Dermatology Specialty Clinic, 1St Floor
Foxborough, MA 02035-1375

Phone

(508) 718-4010

Fax

(508) 718-4011

NPI assigned

Aug 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shroba.suzanne.bwh@direct.partners.masshiway.net

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.

• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment Care Compare group
• Brigham and Women'S Hospital

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1093885816
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1891703518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PATRIOT PL",
            "address_2": "DERMATOLOGY SPECIALTY CLINIC, 1ST FLOOR",
            "city": "FOXBOROUGH",
            "state": "MA",
            "postal_code": "020351375",
            "telephone_number": "508-718-4010",
            "fax_number": "508-718-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PATRIOT PL",
            "address_2": "DERMATOLOGY SPECIALTY CLINIC, 1ST FLOOR",
            "city": "FOXBOROUGH",
            "state": "MA",
            "postal_code": "020351375",
            "telephone_number": "508-718-4010",
            "fax_number": "508-718-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHROBA",
        "first_name": "SUZANNE",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "154413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3172589",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "154413",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominique Serio, PA-C
• Anna Shapiro, PA
• Jordan Shimoda, ATC
• Joy Lyn Shine, P.T.
• Deborah Short, RPH
• Silver Fern Practice, LLC
• Kailyn Smith
• Matthew S Smith
• Derek C Sople, PT, DPT
• Ruth Aimee Sotelo, LICSW

• Dermatology Physician in Foxborough, MA
• Providers in Foxborough, MA by specialty
• Dermatology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.