Individual provider Active NPI

Shmuel Mahgerefteh, M.D.

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1124430947
Registry record updated Jun 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A142017 Issued in CA
Practice address
800 Spruce St
Pennsylvania Hospital - Department of Radiology
Philadelphia, PA 19107-6130
Phone
(215) 829-6657
Fax
(215) 829-7482
NPI assigned
May 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A142017 CA Primary
Internal Medicine Physician 207R00000X A142017 CA

Addresses

Primary practice location

800 Spruce St
Pennsylvania Hospital - Department of Radiology
Philadelphia, PA 19107-6130

Mailing address

800 Spruce St
Pennsylvania Hospital - Department of Radiology
Philadelphia, PA 19107-6130
Phone (215) 829-6657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 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

Enrollment IDStateProvider typePAC IDDetails
I20180622001815 CA Practitioner - Diagnostic Radiology 1456606052 Reassigns benefits to 1 organization
I20210217000719 WA Practitioner - Diagnostic Radiology 1456606052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Advanced Imaging Medical Group IncGroup PAC ID 1557379096, 13 clinicians

Practice addresses (Care Compare)

10767 Riverside Dr
North Hollywood, CA 91602-2324
Phone (818) 301-6700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A142017CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Advanced Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Art Oncology Inc Internal Medicine Current Accepting new patients
Grant County Public Hospital District 3 CurrentSince Dec 31, 2020 Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology PastSince Jun 18, 2018 Accepting new patients
University Radiology Network Inc Diagnostic Radiology Past Accepting new patients

Locations

145 S Doheny Dr
Beverly Hills, CA 90211
Phone (310) 550-5858

2560 W Olympic Blvd
Ste 100
Los Angeles, CA 90006
Phone (323) 703-1000

10767 Riverside Dr
North Hollywood, CA 91602
Phone (818) 301-6700

18388 Clark St
Ste 115
Tarzana, CA 91356
Phone (818) 609-0911

23456 Hawthorne Blvd
Ste 120
Torrance, CA 90505
Phone (818) 710-6011

14915 Burbank Blvd
Van Nuys, CA 91411
Phone (818) 909-7111

7345 Medical Center Dr
Ste 130
West Hills, CA 91307
Phone (818) 710-6011

200 Nat Washington Way
Ephrata, WA 98823
Phone (509) 754-3330

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780704000000",
    "number": "1124430947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "address_2": "PENNSYLVANIA HOSPITAL - DEPARTMENT OF RADIOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-6657",
            "fax_number": "215-829-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "address_2": "PENNSYLVANIA HOSPITAL - DEPARTMENT OF RADIOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-6657",
            "fax_number": "215-829-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHGEREFTEH",
        "first_name": "SHMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-28",
        "last_updated": "2026-06-06",
        "certification_date": "2026-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A142017",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A142017",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.