Individual provider Active NPI

Michael Francis Shulo, CRNA, MSA

  • Certified Registered Nurse Anesthetist
  • Allentown, PA
National Provider Identifier
1275588378
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN232839L Issued in PA
Practice address
5100 W Tilghman St Ste 315
Allentown, PA 18104-9166
Phone
(610) 395-4044
Fax
(610) 395-5693
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN232839L PA
Specialist 174400000X AANA#034631 PA
Certified Registered Nurse Anesthetist 367500000X RN232839L PA Primary

Addresses

Primary practice location

5100 W Tilghman St Ste 315
Allentown, PA 18104-9166

Mailing address

PO Box 783497
Philadelphia, PA 19178-3497
Phone (610) 395-4044

Other identifiers 1

IdentifierTypeStateIssuer
50077442OtherPACAPITAL BLUE CROSS, KEYSTONE CENTRAL, SENIOR BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
AANA#034631PAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Gastroenterology Associates of Lancaster, LTD. Past Accepting new patients
Ephrata Community Hospital PastSince Feb 16, 2020 Accepting new patients
Clinical Pain Management Associates, PC Past Accepting new patients
Mount Nittany Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients
Westwyo Services LP PastSince May 1, 2015 Accepting new patients

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1275588378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783497",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783497",
            "telephone_number": "610-395-4044",
            "fax_number": "610-395-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TILGHMAN ST STE 315",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181049166",
            "telephone_number": "610-395-4044",
            "fax_number": "610-395-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULO",
        "first_name": "MICHAEL",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "CRNA, MSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN232839L",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "AANA#034631",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN232839L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS, KEYSTONE CENTRAL, SENIOR BLUE",
            "identifier": "50077442",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.