DREW SHELDON MD
NPI 1396190484
Internal Medicine - Critical Care Medicine in Weymouth, MA

Active since April 26, 2016PECOS EnrolledAccepts Medicare Assignment
82.78/100
CMS Quality Rating
55 FOGG RD, WEYMOUTH, MA 02190(781) 624-8000 Get Directions Write a Review

NPPES record last updated: December 16, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 16, 2022, Jun 17, 2021 (2 updates tracked since 2021).

About Drew Sheldon Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DREW SHELDON MD (NPI 1396190484) is an individual critical care medicine provider in Weymouth, Massachusetts, licensed in Massachusetts (294667) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with South Shore Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1396190484
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameDREW SHELDONCredential: MD
Location Address55 FOGG RDWeymouth, MA 02190-2432
Mailing Address724 E 4th StBoston, MA 02127-3142 · (661) 201-4025
Sole ProprietorYes
Medical School CMSLoma Linda University School Of MedicineGraduated 2016
Enumeration DateApril 26, 2016
Last NPPES UpdateDecember 16, 20222 updates tracked since enumeration
NPPES CertifiedDecember 16, 2022
✔ NPI 1396190484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
Licenses✔ Licensed in MA · 294667✔ Licensed in CA · A153942
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedInternal MedicineTaxonomy 207R00000X · License A153942 (CA)
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License A153942 (CA)
55 FOGG RD, Weymouth, MA 02190

Secondary Practice Locations 2

Location 1101 The City Dr SOrange, CA 92868-3201 · Phone (714) 456-7890
Location 22051 Marengo StLos Angeles, CA 90033-1352 · Phone (323) 409-1000

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Drew Sheldon Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3274896667
PECOS Enrollment IDI20221004001616
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Drew Sheldon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Anesthesiology
55 FOGG RD
Weymouth, MA 02190
  • Reassigned Medicare billing, Massachusetts enrollment
  • 671 clinicians in this Medicare group
Hospitalist
101 THE CITY DR S BLDG 1
Orange, CA 92868
  • Reassigned Medicare billing, California enrollment
  • 250 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
193 services116 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
48 services33 patients
Critical care, each additional 30 minutes 99292
Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.
35 services23 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
21 services17 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

South Shore Hospital

Acute Care Hospitals · South Weymouth, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220100
Location55 Fogg RoadSouth Weymouth, MA 02190 · Norfolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02190 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

82.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality88.33
Promoting Interoperability70
Improvement Activities40
Cost69.53

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dietitian, Registered
55 FOGG RD
WEYMOUTH, MA 02190
Radiology (Diagnostic Radiology)
55 FOGG RD
WEYMOUTH, MA 02190
Dietitian, Registered
55 FOGG RD
WEYMOUTH, MA 02190
Dietitian, Registered
55 FOGG RD
SOUTH WEYMOUTH, MA 02190
Nurse Practitioner (Psychiatric/Mental Health)
55 FOGG RD
WEYMOUTH, MA 02190
Pediatrics
55 FOGG RD
S WEYMOUTH, MA 02190
Social Worker (Clinical)
55 FOGG RD
WEYMOUTH, MA 02190
Student in an Organized Health Care Education/Training Program
55 FOGG RD
SOUTH WEYMOUTH, MA 02190

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Drew Sheldon's NPI number?

The NPI number for Drew Sheldon is 1396190484. It was assigned to this individual provider in the NPPES registry on April 26, 2016.

Where is Drew Sheldon located?

Drew Sheldon practices at 55 Fogg Rd, Weymouth, MA 02190. The listed phone number is (781) 624-8000.

What is Drew Sheldon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Drew Sheldon enrolled in Medicare?

Yes. Drew Sheldon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Drew Sheldon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Drew Sheldon reassigns Medicare benefits to 2 organizations: Coastal Medical Associates (Weymouth, MA) and The Regents Of The University Of California-Irvine (Orange, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Drew Sheldon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Drew Sheldon accept?

Health plans from Taro Health list Drew Sheldon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Drew Sheldon affiliated with any hospitals?

According to CMS data, Drew Sheldon is affiliated with South Shore Hospital.

When was this NPI record last updated?

The NPPES record for Drew Sheldon was last updated on December 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.