Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marni Shore, PA-C

Individual provider Physician Assistant · NPI 1801640156

Marni Shore, PA-C is a Physician Assistant in Boston, Massachusetts. Qualified in 2024, 2 years ago. Registered with an NPI since 2024.

Years since qualifying
2
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

450 Brookline Ave
Boston, MA 02215-5418
Phone: (215) 941-0472
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1801640156
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 15, 2024
Last updated in NPPESJanuary 7, 2026
Certification dateJanuary 7, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

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