Carly Ann Shiembob, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DO2537 Issued in ME

Practice address

10800 Knights Rd
Philadelphia, PA 19114-4200

Phone

(215) 612-4000

NPI assigned

Jun 8, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ME, NH2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

71.7 of 100Reported as group

Quality

64.24

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cshiembob83859@direct.bilh.masshiway.net

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.

• Emergency Medicine Physicians of Rockingham County, LLC

  • Emergency Medicine Physician
  • Exeter, NH
  • NPI 1174956668
  Medicare reassignment NPD
• Emergency Medicine Services of NH, LLC

  • Emergency Medicine Physician
  • Derry, NH
  • NPI 1386341444
  Medicare reassignment NPD
• Mainehealth

  • General Acute Care Hospital
  • Biddeford, ME
  • NPI 1659392819
  Medicare reassignment NPD
• Seacoast Emergency Physicians, PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Dover, NH
  • NPI 1134155872
  Medicare reassignment NPD
• Mainehealth

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  • Multi-Specialty Clinic/Center
  • Biddeford, ME
  • NPI 1215417019
  NPD
• Mainehealth

  • Skilled Nursing Facility
  • Sanford, ME
  • NPI 1447342209
  NPD
• Mainehealth

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  NPD
• Seacoast Emergency Physicians PC

  • Emergency Medicine Physician
  • Lee, NH
  • NPI 1740410133
  NPD
• On Demand Urgent Care Group PC

  • Urgent Care Clinic/Center
  • Philadelphia, PA
  • NPI 1881083723
  NPD (past)

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1114247566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Biddeford",
            "state": "ME",
            "postal_code": "040059422",
            "country_code": "US",
            "telephone_number": "207-294-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIEMBOB",
        "first_name": "CARLY",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT013357",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT013357",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS015723",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "DO2537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Shields
• Kerry Shields, RN,PCCNP
• Mary Catherine Shields, MD
• Rachel Kelley Shields, MSN
• Shaun Shields
• Stephanie Marie Shiffler, PH.D.
• Eric Jason Shiffrin, M.D.
• Norihisa Shigemura, MD
• Evelyn Shih, MD, PHD
• Ajay Anu Shiji

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.