Individual provider Active NPI

Scott A Shikora, MD, FACS

  • Surgery Physician
  • Brookline, MA
National Provider Identifier
1902917446
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
57931 Issued in MA
Practice address
111 Cypress St
Brookline, MA 02445-6002
Phone
(857) 307-0986
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 57931 MA Primary

Addresses

Primary practice location

111 Cypress St
Brookline, MA 02445-6002

Mailing address

75 Francis Street
Asbii-3Rd Floor
Boston, MA 02115
Phone (617) 525-8570

Other identifiers 1

IdentifierTypeStateIssuer
3032001MedicaidMA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406001152 MA Practitioner - General Surgery 6305893819 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57931MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sturdy Memorial Hospital Inc CurrentSince Jun 1, 2016 Accepting new patients
Sturdy Health, Inc. Past Accepting new patients

Locations

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1902917446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS STREET",
            "address_2": "ASBII-3RD FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-525-8570",
            "fax_number": "617-734-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CYPRESS ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024456002",
            "telephone_number": "857-307-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIKORA",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "57931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3032001",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.