Safiyya Shabazz, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD0428070 Issued in PA

Practice address

22 E Mount Airy Ave
Philadelphia, PA 19119

Phone

(215) 924-2440

NPI assigned

Jun 29, 2006

Last updated

Jul 27, 2018By the provider in NPPES

Sex

Female

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

Family Practice

Education

Perelman School of Med at the University of Pennsylvania, 2002

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142
• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
• Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6790/brand/1/csg/1/fhir/r4
• Direct secure messaging: safiyya.shabazz.1@18824.direct.athenahealth.com
• Direct secure messaging: safiyya.shabazz.1@6790.direct.athenahealth.com

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.

• Fountain Medical Associates P C

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1215257837
  Medicare reassignment Authorized official

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

• Einstein Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1366653818
  Care Compare affiliation Name & address match
• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• The Pennsylvania Hospital of the University of Pennsylvania Health Sys

  • General Acute Care Hospital
  • Phila, PA
  • NPI 1063489342
  Care Compare affiliation
• Trustees of the University of Pennsylvania

  dba Hospital 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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1033147178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 E MOUNT AIRY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191191712",
            "telephone_number": "215-924-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 E MOUNT AIRY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19119",
            "telephone_number": "215-924-2440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E Germantown Pike",
            "address_purpose": "LOCATION",
            "city": "East Norriton",
            "state": "PA",
            "postal_code": "194016506",
            "country_code": "US",
            "telephone_number": "610-994-0063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHABAZZ",
        "first_name": "SAFIYYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD0428070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Safiya Shabazz-Evans
• Aisha R Shabazz, LCSW
• Lateefah Shabazz
• Lennisa Cheryl Shabazz, OTR/L
• Nefertitti Shabazz
• Danya Leigh Shabi, DMD
• Leah Shabo, MD
• Nogah Shabshin, MD
• Jonathan Shack, MD
• Ashley L Shackelford

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.