Henrietta D Mtshali, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA003230L Issued in PA

Practice address

2100 W Girard Ave
Philadelphia, PA 19130-1400

Phone

(215) 685-0800

Fax

(215) 865-0846

NPI assigned

Dec 13, 2007

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

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Methodist Associates in Healthcare, IncGroup PAC ID 6406755651, 387 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Methodist Associates in Healthcare, Inc

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053355131
  Medicare reassignment Care Compare group
• Methodist Associates in Healthcare, Inc

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
  • NPI 1508516451
  NPD
• Methodist Associates in Healthcare, Inc

  dba Jefferson Community Physicians - Neurosurgery

  • Neurological Surgery Physician
  • Philadelphia, PA
  • NPI 1790390813
  NPD
• Jefferson University Physicians

  dba Jefferson GI

  • Gastroenterology Physician
  • Phila, PA
  • NPI 1205898723
  NPD (past)
• Temple Physician Inc.

  • Internal Medicine Physician
  • Feasterville Trevose, PA
  • NPI 1174497366
  NPD (past)
• Temple Physicians Inc

  • Internal Medicine Physician
  • Phila, PA
  • NPI 1639496391
  NPD (past)
• Temple Physicians Inc

  • Family Medicine Physician
  • Flourtown, PA
  • NPI 1952642936
  NPD (past)
• Temple Physicians Inc

  • Internal Medicine Physician
  • Phila, PA
  • NPI 1982680526

  Medical

  NPD (past)
• Temple Physicians Inc.

  • Advanced Practice Midwife
  • Philadelphia, PA
  • NPI 1669524823
  NPD (past)

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

• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1043493901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483542",
            "telephone_number": "215-952-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W GIRARD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301400",
            "telephone_number": "215-685-0800",
            "fax_number": "215-865-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MTSHALI",
        "first_name": "HENRIETTA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA003230L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "597586",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CD4829",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jahi B Mtaalamu, DDS
• Jeanette Mtanos, LMFT
• MTC Wellness, LLC
• MTP RX LLC (Medical Tower Pharmacy)
• MTP RX LLC (Medical Tower Pharmacy)
• Scott Mu
• Yusuf Quinton Mu'Min, LCSW
• Haitem Mohamed Muafa
• Tiba Muath, RPH
• Fareeha Mubin, MD

• Medical Physician Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.