Individual provider Active NPI

Michelle D Walter, PA

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1124168745
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
008209 Issued in NY
Practice address
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone
(215) 456-6598
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 008209 NY Primary
Medical Physician Assistant 363AM0700X MA052932 PA

Addresses

Primary practice location

5501 Old York Rd
Philadelphia, PA 19141-3018

Mailing address

1225 Waverly Walk
Philadelphia, PA 19147-1147
Phone (215) 546-6598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180216001494 PA Practitioner - Physician Assistant 8921368705 Reassigns benefits to 1 organization
I20230112002281 NY Practitioner - Physician Assistant 8921368705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Critical Care Physicians of Pennsylvania PCGroup PAC ID 2466610498, 51 clinicians

Practice addresses (Care Compare)

1500 Lansdowne Ave
Darby, PA 19023-1200
Phone (866) 212-7753

2601 Holme Ave
Philadelphia, PA 19152-2007
Phone (866) 212-7753

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008209NYMDMental Health Counselor
MA052932PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Jul 15, 2024 Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

Interoperability endpoints

  • Direct secure messaging: mwalter69314@northwell.direct-ci.com
  • Direct secure messaging: michelle.walter@direct.einstein.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1124168745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 WAVERLY WALK",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471147",
            "telephone_number": "215-546-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "MICHELLE",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "008209",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA052932",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.