Individual provider Active NPI

Marina Shainsky, MD

  • Psychiatry Physician
  • Ambler, PA
National Provider Identifier
1023273158
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD447178 Issued in PA
Practice address
722 E Butler Pike
Ambler, PA 19002-2310
Phone
(215) 643-7800
NPI assigned
Jul 29, 2008
Last updated
Aug 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 193673 PA
Psychiatry Physician 2084P0800X MD447178 PA Primary

Addresses

Primary practice location

722 E Butler Pike
Ambler, PA 19002-2310

Mailing address

722 E Butler Pike
Ambler, PA 19002-2310
Phone (215) 643-7800

Other names 1

  • Marina Petlakh Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130912000042 PA Practitioner - Psychiatry 8921242082 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York at Buffalo School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

722 E Butler Pike
Ambler, PA 19002-2310
Phone (215) 643-7800

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
78.42
Improvement activities
40
Cost
70.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
193673PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Pennsylvania Physician Alliance LLC CurrentSince Jun 1, 2020 Accepting new patients
Uhs of Pennsylvania Inc Psychiatry Current Accepting new patients
Uhs of Pennsylvania Inc Psychiatry CurrentSince Apr 18, 2017 Accepting new patients
Joseph Dantonio MD PC Psychiatry PastSince Jun 1, 2015 Accepting new patients

Locations

800 Park Way
Ste A
Broomall, PA 19008
Phone (215) 718-4350

2 Hospital Dr
Clarion, PA 16214
Phone (800) 253-4906

722 E Butler Pike
Maple Glen, PA 19002
Phone (215) 643-7800

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1023273158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 E BUTLER PIKE",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190022310",
            "telephone_number": "215-643-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 E BUTLER PIKE",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190022310",
            "telephone_number": "215-643-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAINSKY",
        "first_name": "MARINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "193673",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD447178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "PETLAKH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ambler, PA

Sources for this page

Verify at the official NPI Registry.