Sheku M Idriss, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS009974L Issued in PA

Practice address

1821 Fulton St
Harrisburg, PA 17102-1522

Phone

(717) 230-3906

Fax

(717) 230-3914

NPI assigned

Sep 25, 2006

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

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.

• The Behavioral Wellness Center at Girard

  • Methadone Clinic
  • Philadelphia, PA
  • NPI 1598798928
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104926526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 FULTON ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171021522",
            "telephone_number": "717-230-3906",
            "fax_number": "717-230-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 FULTON ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171021522",
            "telephone_number": "717-230-3906",
            "fax_number": "717-230-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDRISS",
        "first_name": "SHEKU",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS009974L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Elizabeth Ibach
• Kaitlyn Ibberson, PMHNP
• Emmerlyn E Iberedem, RPH
• Ideal Home, LLC
• Ideal Services Group LLC
• Oghogho Igbinoba, MD
• Ih Physician Services PC
• Sheri Kay Ihm, MSPT
• Austin Chinonso Ikechi, MD
• Muhammad Ikram, MD

• Family Medicine Physician in Harrisburg, PA
• Providers in Harrisburg, 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 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.