Active NPI
Rui Shao
- Pediatric Nurse Practitioner
- Quincy, MA
National Provider Identifier
1992122683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN2291820
- Practice address
- 88 Holmes St
Quincy, MA 02171-2431 - Phone
- (617) 318-3200
- Fax
- (617) 318-3291
- NPI assigned
- Mar 19, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN2291820 | MA | |
| Pediatric Nurse Practitioner | 363LP0200X | RN2291820 | MA | Primary |
Addresses
Primary practice location
88 Holmes St
Quincy, MA 02171-2431
Mailing address
88 Holmes St
Quincy, MA 02171-2431
Phone (617) 318-3200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2291820 | MA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438128000000",
"number": "1992122683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 HOLMES ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021712431",
"telephone_number": "617-318-3200",
"fax_number": "617-318-3291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 HOLMES ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021712431",
"telephone_number": "617-318-3200",
"fax_number": "617-318-3291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAO",
"first_name": "RUI",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-19",
"last_updated": "2015-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "RN2291820",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MA",
"license": "RN2291820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.