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1780680488

NPI Code Detail

MEDICARE: MICHAEL S SHUSTERMAN MD

MEDICARE: MICHAEL S SHUSTERMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	160164	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	A29870	OTHER		MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160164	OTHER		TUFTS COMMONWEALTH PRO
2	160164	OTHER		TUFTS BENEFIT ADMIN
3	160164	OTHER		TUFTS TOTAL HEALTH PLAN
4	MH1549	OTHER		FIRST SENIORITY
5	1545423	OTHER		CIGNA HEALTH CARE
6	160164	OTHER		TUFTS
8	J21503	OTHER		HMO BLUE/BLUE CHOICE
9	202046	OTHER		HARVARD PILGRIM POS
10	27712	OTHER		CHILDREN'S MEDICAL SECURI
11	0018167	OTHER		NEIGHBORHOOD HEALTH PLAN
12	1240697	OTHER		UNITED HEALTHCARE(PPO)
13	1545423	OTHER	MA	HEALTHSOURCE
14	202046	OTHER		HARVARD PILGRIM PPO
15	3194647	OTHER		MASS HEALTH
16	J21503	OTHER		BLUE SHIELD-INDEMNITY
17	202046	OTHER		HARVARD/PILGRIM
18	J21503	OTHER		BS-BLUE CARE ELECT

General Provider Information

NPI Number	:	1780680488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL S SHUSTERMAN MD

Provider Business Mailing Address
First Line	:	1 LYONS ST
Second Line	:
City	:	DEDHAM
State	:	MA
Zip	:	02026-5599
Country	:	US
Telephone Number	:	781-493-3620
Fax Number	:	781-461-9210

Provider Business Practice Location Address
First Line	:	1 LYONS ST
Second Line	:
City	:	DEDHAM
State	:	MA
Zip	:	02026-5599
Country	:	US
Telephone Number	:	781-493-3620
Fax Number	:	781-461-9210

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	03/07/2021

Similar Medicare Providers

1376541631 — MARGARET M HOFFMAN NP
Practice Location Address:

1 LYONS ST
DEDHAM, MA
02026-5599

Practice Phone: 781-329-1400
Practice Fax: 781-278-5664

1205832821 — JENNIFER K FEHSER MD
Practice Location Address:

1 LYONS ST
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02026-5599

Practice Phone: 781-329-1400
Practice Fax: 781-278-5667

1811993447 — MICHAEL FERRIS MD
Practice Location Address:

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Practice Phone: 781-329-1400
Practice Fax: 781-278-5667

1609872233 — R MATTHEW MINER D.D.S.
Practice Location Address:

1 LYONS ST
DEDHAM, MA
02026-5599

Practice Phone: 781-329-1400
Practice Fax: 781-278-5667

1790782324 — NAN E NILAND DDS
Practice Location Address:

1 LYONS ST
DEDHAM, MA
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Practice Phone: 781-329-1400
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1659378289 — TERRI LOEWENTHAL CCC-A
Practice Location Address:

1 LYONS ST
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Practice Phone: 781-329-1400
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Directions to “ MICHAEL S SHUSTERMAN MD” Practice Location

Language	Start Address	Practice Location

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