LISETTA D. SHAH (M.D.) – Family Medicine Physician, NPI 1205221900
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,900 FAMILY PRACTICE in MA
Provider Addresses for LISETTA D. SHAH (M.D.)
650 LINCOLN ST
WORCESTER, MA 016052060
Phone:
Type: Mailing
19 TACOMA ST
WORCESTER, MA 01605
Phone: (508) 852-1805
Type: Location
5 Neponset St
Worcester, MA 016062714
Phone: (508) 425-5566
Fax: (508) 365-6590
Type: Location
5 Neponset Street
Worcester, MA 016062714
Phone:
Type: Location
151 Worcester Rd
Barre, MA 010059002
Phone: (978) 355-9222
Type: Location
19 Tacoma St
Worcester, MA 01605
Phone: (508) 852-1805
Type: Location
5 NEPONSET ST FL CENTER12
WORCESTER, MA 016062714
Phone: (088) 520-6005
Type: Mailing
5 NEPONSET STREET
WORCESTER, MA 016062714
Phone:
Type: Location
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: 2019-03-20
PECOS data refreshed: 2026-05-27
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 |
|---|---|---|---|---|
| I20190320000132 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 01605)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | MA | |
| Internal Medicine | MA | |
| - | MA | |
| - | MA | |
| Emergency Medicine | MA | |
| Physical Therapist In Private Practice | MA | |
| Physician Assistant | MA | |
| Family Practice | MA | |
| Clinical Psychologist | MA | |
| - | MA |
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