Active NPI
Michelle D Walter, PA
- Medical Physician Assistant
- Philadelphia, PA
National Provider Identifier
1124168745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 008209
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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
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 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 008209 | NY | MD | Mental Health Counselor |
| MA052932 | PA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore - Lij Medical PC | Current | 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
- mwalter69314@northwell.direct-ci.com
- 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.
-
- Critical Care Medicine (Internal Medicine) Physician
- Darby, PA
- NPI 1952670085
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1790043479
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; 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.