Active NPI
Kareen Shebaclo, MD
- Ophthalmology Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- ME176400
- Practice address
- 840 Walnut St Ste 910
Philadelphia, PA 19107-5109 - Phone
- (215) 928-3250
- Fax
- (215) 928-3276
- NPI assigned
- Jul 17, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmic Plastic and Reconstructive Surgery Physician | 207WX0200X | MD478276 | PA | |
| Ophthalmology Physician | 207W00000X | ME176400 | FL | Primary |
| Ophthalmology Physician | 207W00000X | MD478276 | PA |
Addresses
Primary practice location
840 Walnut St Ste 910
Philadelphia, PA 19107-5109
Mailing address
840 Walnut St Ste 910
Philadelphia, PA 19107-5109
Phone (215) 928-3250
Other practice location 1
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kshebaclo2560148@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, NJ, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Georgetown University School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.89 of 100
- Quality
- 95.81
- Promoting interoperability
- 94
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.34 of 100
- Quality
- 80.85
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.95
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 11 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD478276 | PA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Jacksonville | Current | Accepting new patients | |
| Annesley Flanagan Fischer Stefanyszyn and Associates | Ophthalmology | Current | Accepting new patients |
| Wills Eye Ophthalmology Clinic, Inc | Ophthalmology | Current | Accepting new patients |
| Mayo Clinic Jacksonville | Current | Accepting new patients | |
| Edmonds & Associates LLC | Past | Accepting new patients |
Locations
4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815
775 Route 70 E
Marlton, NJ 08053
Phone (856) 596-1601
775 Route 70 E
Ste F180
Marlton, NJ 08053
Phone (856) 596-1601
840 Walnut St
Ste 1230
Philadelphia, PA 19107
Phone (215) 440-3160
840 Walnut St
Ste 910
Philadelphia, PA 19107
Phone (215) 928-3250
100 E Lancaster Ave
Ste 54
Wynnewood, PA 19096
Phone (610) 645-3337
54 Lankenau Medical Building E
Wynnewood, PA 19096
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- https://fhir4.healow.com/fhir/r4/EDBFBA
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1790772317
-
- Ophthalmic Plastic and Reconstructive Surgery Physician
- Wynnewood, PA
- NPI 1396731501
NJ, Ophthalmology
-
- Ophthalmology Physician
- Philadelphia, PA
- NPI 1184624009
-
- Home Infusion Therapy Pharmacy
- Jacksonville, FL
- NPI 1003510116
-
- Optometrist
- Drexel Hill, PA
- NPI 1285931709
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1891782470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759276800000",
"number": "1063935542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 WALNUT ST STE 910",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075109",
"telephone_number": "215-928-3250",
"fax_number": "215-928-3276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 WALNUT ST STE 910",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075109",
"telephone_number": "215-928-3250",
"fax_number": "215-928-3276"
}
],
"practiceLocations": [
{
"address_1": "4500 San Pablo Rd S",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322241865",
"country_code": "US",
"telephone_number": "904-953-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHEBACLO",
"first_name": "KAREEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-17",
"last_updated": "2025-10-01",
"certification_date": "2025-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "207WX0200X",
"taxonomy_group": "",
"desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
"state": "PA",
"license": "MD478276",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "FL",
"license": "ME176400",
"primary": true
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "PA",
"license": "MD478276",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kshebaclo2560148@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "4500 San Pablo Rd S",
"city": "Jacksonville",
"state": "FL",
"country_code": "US",
"postal_code": "322241865",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.