Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Susan Clare Shaddock, CNP

Individual provider Nurse Practitioner · NPI 1073036554

Susan Clare Shaddock, CNP is a Nurse Practitioner in Worcester, Massachusetts. Qualified in 2017, 9 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
9
Licensed in
MA
In the registry since
2017
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

55 Lake Ave N
Worcester, MA 01655-0002
Phone: (774) 443-7552
Fax: (774) 441-6086
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 119 Belmont St, Worcester, MA 01605-2903 — (774) 443-7552

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN2304241 (MA)

Record details

NPI number1073036554
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP
Sole proprietorNo
NPI enumeratedJuly 17, 2017
Last updated in NPPESOctober 27, 2020
Certification dateOctober 27, 2020
Mailing addressPo Box 415348, Boston, MA 02241-5348

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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