SAMUEL SHAW-WILGOSKI (PMHNP) – Child & Family Psychiatric/Mental Health Clinical Nurse Specialist, NPI 1629834452

SAMUEL SHAW-WILGOSKI (PMHNP) is a healthcare provider. based in Framingham, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. RN2324798 (MA). The NPI Number for SAMUEL SHAW-WILGOSKI (PMHNP) is 1629834452

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
SAMUEL SHAW-WILGOSKI (PMHNP)
NPI
1629834452
Phone
(508) 834-3183
Address
1881 WORCESTER RD STE 203
Enumeration Date
28 February 2024
Last Update Date
8 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5088343183
Graduation Year
2023 (3 years ago)
PAC ID
2860923455
Group Practice PAC ID
9638234750
Professional Enrollment ID
I20241007003328
Address ID
MA017015410FR1881XRDXX305
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:2State licenses:1Digital endpointsOther names

8,972 NURSE PRACTITIONER in MA

Provider Addresses for SAMUEL SHAW-WILGOSKI (PMHNP)

  • 1881 WORCESTER RD STE 203

    FRAMINGHAM, MA 017015410

    Phone: (508) 834-3183

    Fax: (508) 532-1168

    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)

CMS reports 3 Open Payments records for all available years, with a total value of $69.

Total Amount is formed as General ($69) + Research ($0) + Ownership ($0) = $69.

Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Lundbeck LLC ($26).

Total Amount

$69

General + Research + Ownership

Payments

3

Total payment records

General Amount

$69

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-10-07

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241007003328INurse PractitionerMATBD

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.

Verify on CMS Revalidation Lookup Tool

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 01701)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638234750View full group profile
NameSpecialtyState
Certified Clinical Nurse Specialist (Cns)MA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA

Reviews

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Frequently asked questions

What NPI should I save for SAMUEL SHAW-WILGOSKI (PMHNP)?
Save NPI 1629834452 if you need a stable reference for SAMUEL SHAW-WILGOSKI (PMHNP).
Is SAMUEL SHAW-WILGOSKI (PMHNP) active in the national directory?
SAMUEL SHAW-WILGOSKI (PMHNP)'s public NPI profile is in an active state.
Does SAMUEL SHAW-WILGOSKI (PMHNP) list a primary specialty?
If you are matching referrals, note Child & Family Psychiatric/Mental Health Clinical Nurse Specialist for SAMUEL SHAW-WILGOSKI (PMHNP). Clinical services aligned with this taxonomy classification.
What location metadata exists for SAMUEL SHAW-WILGOSKI (PMHNP)?
The page summarizes Framingham, Massachusetts for SAMUEL SHAW-WILGOSKI (PMHNP); expand the address list for detail.
What if Framingham, Massachusetts seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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