Jason Michael Shackelford, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD436110 Issued in PA

Practice address

500 Old York Rd
Suite 203
Jenkintown, PA 19046-2852

Phone

(215) 886-0174

Fax

(215) 886-9217

NPI assigned

Sep 18, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Temple University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Doylestown Hospital Hospital, Doylestown, PA, CCN 390203
• St Luke'S Hospital - Grand View Campus Hospital, Sellersville, PA, CCN 390057
• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jason.shackelford@advocaredoctors.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advocare, LLC

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1770538696

  Internal Medicine, PA

  Medicare reassignment Care Compare group NPD
• Advocare , LLC

  • Internal Medicine Physician
  • Manahawkin, NJ
  • NPI 1912762162
  NPD
• Advocare, LLC

  • Pediatrics Physician
  • Cherry Hill, NJ
  • NPI 1780696732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Doylestown Hospital

  • General Acute Care Hospital
  • Doylestown, PA
  • NPI 1225091697
  Care Compare affiliation
• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• St. Luke'S Hospital Grand View Campus

  • General Acute Care Hospital
  • Sellersville, PA
  • NPI 1568459287
  Care Compare affiliation
• Trustees of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1023204534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 OLD YORK RD",
            "address_2": "SUITE 203",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462852",
            "telephone_number": "215-886-0174",
            "fax_number": "215-886-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 OLD YORK RD",
            "address_2": "SUITE 203",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462852",
            "telephone_number": "215-886-0174",
            "fax_number": "215-886-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKELFORD",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-18",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD436110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John R Seader, PHD
• Christopher Michael Senske
• Samina Seraj, MD
• Sethi Orthodontics PLLC
• Anshuman Sethi, DMD, MSD
• Meera Shah, D.O.
• Adam Shambaugh
• Emily Elizabeth Shangle, OTR/L
• Donald Shapiro, M.D., M.P.H.
• Ronald Shapiro, RPH

• Internal Medicine Physician in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.