Individual provider Active NPI

Yuri Shamritsky, DMD, DDS

  • Endodontics
  • Peabody, MA
National Provider Identifier
1902829104
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
18155 Issued in MA
Practice address
6 Essex Center Dr
110
Peabody, MA 01960-2910
Phone
(978) 532-0500
Fax
(978) 977-3458
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 18155 MA Primary

Addresses

Primary practice location

6 Essex Center Dr
110
Peabody, MA 01960-2910

Mailing address

6 Essex Center Dr
110
Peabody, MA 01960-2910
Phone (978) 532-0500

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150707001994 MA Order and Referring Only - DentistPractitioner - Dentist 0840502761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18155MAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Endodontic Associates, P.C. Endodontics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902829104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ESSEX CENTER DR",
            "address_2": "110",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602910",
            "telephone_number": "978-532-0500",
            "fax_number": "978-977-3458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ESSEX CENTER DR",
            "address_2": "110",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602910",
            "telephone_number": "978-532-0500",
            "fax_number": "978-977-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMRITSKY",
        "first_name": "YURI",
        "name_prefix": "Dr.",
        "credential": "DMD, DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "18155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.