SHRUTI PATHAK (MD) – Family Medicine Physician, NPI 1124301304
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,906 FAMILY PRACTICE in MA
Provider Addresses for SHRUTI PATHAK (MD)
63 MAIN ST
BROCKTON, MA 023014042
Phone: (508) 559-6699
Fax: (508) 559-5073
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-11-06
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20141106000463 | I | Family Practice | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 82947 | Blood glucose (sugar) level | 107 | 36 | $0 |
| 83036 | Hemoglobin a1c level | 37 | 28 | $0 |
| G0008 | Administration of influenza virus vaccine | 21 | 21 | $0 |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 19 | 15 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 13 | 12 | $0 |
Insurance plans in this area (ZIP 02301)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | MA | 83036 | Hemoglobin A1C level | 42 | 24 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MA | |
| - | MA | |
| - | MA | |
| - | MA | |
| - | MA | |
| Family Practice | MA | |
| - | MA | |
| Internal Medicine | MA | |
| Endocrinology, Internal Medicine | MA | |
| - | MA |
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