NPIMap

Individual provider Active NPI

Shaun Plotnick, MD

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1093209975
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD473934 Issued in PA
Practice address
100 E Lehigh Ave
Philadelphia, PA 19125
Phone
(215) 707-8496
Fax
(215) 707-4086
NPI assigned
Jun 14, 2018
Last updated
Dec 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD473934 PA Primary

Addresses

Primary practice location

100 E Lehigh Ave
Philadelphia, PA 19125

Mailing address

3500 N Broad St RM 001a
Philadelphia, PA 19140-4106
Phone (215) 707-8496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220519001714 PA Practitioner - Psychiatry 9436405818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Temple University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

100 E Lehigh Ave
Philadelphia, PA 19125-1012
Phone (215) 707-8496

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince May 11, 2022 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince May 11, 2022 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple University Hospital, Inc - Psych Unit Past Accepting new patients

Locations

100 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 707-1200

100 E Lehigh Ave
Ste 305B
Philadelphia, PA 19125
Phone (215) 707-1200

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1093209975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST RM 001A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106",
            "telephone_number": "215-707-8496",
            "fax_number": "215-707-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LEHIGH AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19125",
            "telephone_number": "215-707-8496",
            "fax_number": "215-707-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOTNICK",
        "first_name": "SHAUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-14",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD473934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.