Individual provider Active NPI

Shamim Ejaz, DO

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1902547300
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1022585 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6106
Phone
(617) 732-5500
NPI assigned
Apr 7, 2022
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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 1022585 MA Primary
Hospitalist Physician 208M00000X 341312 NY

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6106

Mailing address

75 Francis St
Boston, MA 02115-6106
Phone (716) 862-1423

Other practice location 1

2157 Main St Fl 5
Buffalo, NY 14214-2648
Phone (716) 862-1423

Other practice location 2

55 Fruit St
Boston, MA 02114-2696
Phone (617) 726-2000

Other practice location 3

55 Fruit St
Boston, MA 02114-2621
Phone (848) 391-4949

Other practice location 4

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-8600

Other practice location 5

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 525-8600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250709000929 MA Practitioner - Internal MedicinePractitioner - Hospitalist 9537673801 Reassigns benefits to 3 organizations
I20260609001668 NY Practitioner - Internal Medicine 9537673801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1022585MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Mar 8, 2026 Accepting new patients
Brigham & Womens Physicians Organization Inc Internal Medicine CurrentSince Jul 1, 2025 Accepting new patients
Brigham and Women's Hospital Current Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Mar 8, 2026 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

75 Francis St
Boston, MA 02115

62 13th St
Charlestown, MA 02129
Phone (617) 724-4260

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

Interoperability endpoints

  • Direct secure messaging: ejaz.shamim.bwh@direct.partners.masshiway.net

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 4

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": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1902547300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "716-862-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "617-732-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2157 Main St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142142648",
            "country_code": "US",
            "telephone_number": "716-862-1423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142696",
            "country_code": "US",
            "telephone_number": "617-726-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "848-391-4949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 S Manning Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-525-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EJAZ",
        "first_name": "SHAMIM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-07",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "1022585",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "341312",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.