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DR. OLIVER JACOB SHORE MD
NPI 1932849700
Student in an Organized Health Care Education/Training Program in Brookline, MA

Active since March 30, 2022PECOS Enrolled
1842 BEACON ST STE 402, BROOKLINE, MA 02445(617) 987-4455(617) 752-6812 Get Directions Write a Review

NPPES record last updated: February 17, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Oliver Jacob Shore Md NPPES

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

DR. OLIVER JACOB SHORE MD (NPI 1932849700) is an individual student in an organized health care education/training program in Brookline, Massachusetts, licensed in Massachusetts (293497) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Boston.

NPPES Registry Identity

NPI1932849700
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. OLIVER JACOB SHORECredential: MD
Location Address1842 BEACON ST STE 402Brookline, MA 02445-1922
Mailing Address1842 Beacon St Ste 402Brookline, MA 02445-1922 · (617) 987-4455 · Fax (617) 752-6812
Phone(617) 987-4455
Fax(617) 752-6812
Sole ProprietorYes
Enumeration DateMarch 30, 2022
Last NPPES UpdateFebruary 17, 2026
NPPES CertifiedFebruary 17, 2026
✔ NPI 1932849700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in MA · 293497
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 1025311 (MA)
1842 BEACON ST STE 402, Brookline, MA 02445
Open in Google Maps ↗

Secondary Practice Location 1

Location 1330 Brookline Ave # Rabb-2Boston, MA 02215-5400 · Phone (617) 667-7000

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Oliver Jacob Shore Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 3

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

DR. BONNIE WONG PHD
Clinical Neuropsychologist
1842 BEACON ST STE 402
BROOKLINE, MA 02445
Norfolk County (617) 283-9739
DR. ANN E GOEBEL-FABBRI PHD
Psychologist (Clinical)
1842 BEACON ST STE 402
BROOKLINE, MA 02445
Norfolk County (617) 513-9327
DEBORAH K MANEGOLD M.D.
Psychiatry & Neurology (Psychiatry)
1842 BEACON ST STE 402
BROOKLINE, MA 02445
Norfolk County (781) 690-1317

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 Oliver Shore's NPI number?

The NPI number for Oliver Shore is 1932849700. It was assigned to this individual provider in the NPPES registry on March 30, 2022.

Where is Oliver Shore located?

Oliver Shore practices at 1842 Beacon St Ste 402, Brookline, MA 02445. The listed phone number is (617) 987-4455.

What is Oliver Shore's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Oliver Shore enrolled in Medicare?

Yes. Oliver Shore is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Oliver Shore was last updated on February 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.