NPIMap

Individual provider Active NPI

Michael E Srulevich, DO

  • Geriatric Medicine (Family Medicine) Physician
  • Crum Lynne, PA
National Provider Identifier
1275670655
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
OS012617 Issued in PA
Practice address
1553 Chester Pike
Suite 201
Crum Lynne, PA 19022-1022
Phone
(610) 499-7180
Fax
(610) 499-7190
NPI assigned
Feb 1, 2007
Last updated
Oct 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X OS012617 PA Primary

Addresses

Primary practice location

1553 Chester Pike
Suite 201
Crum Lynne, PA 19022-1022

Mailing address

150 Juniper Rd
Havertown, PA 19083-5410
Phone (610) 853-5685

Other identifiers 1

IdentifierTypeStateIssuer
1019420800003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050617000356 PA Practitioner - Family PracticePractitioner - Geriatric Medicine 4486698602 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Philadelphia College of Osteopathic MedicineGroup PAC ID 0648179234, 30 clinicians

Practice addresses (Care Compare)

4190 City Ave
Suite 315
Philadelphia, PA 19131-1633
Phone (215) 871-6384

4190 City Line Ave
Philadelphia, PA 19131-1633

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Residentialist Housecall Med GRP, PC a Pennsylvania Corp Geriatric Medicine CurrentSince Feb 1, 2018 Accepting new patients
Lancaster General Hospital CurrentSince Aug 19, 2013 Accepting new patients
Lancaster General Hospital CurrentSince Aug 19, 2013 Accepting new patients
Lancaster General Hospital Current Accepting new patients
Philadelphia College of Osteopathic Medicine Geriatric Medicine CurrentSince Oct 1, 2015 Accepting new patients
Housecall Doctors Medical Group Inc Geriatric Medicine PastSince Mar 30, 2010 Accepting new patients
Saint Ignatius Nursing Home Past Accepting new patients
Health Access Network Past Accepting new patients

Locations

3800 Kilroy Airport Way
Ste 270
Long Beach, CA 90806
Phone (949) 366-1053

555 N Duke St
Lancaster, PA 17602
Phone (717) 544-5945

4190 City Ave
Ste 528
Philadelphia, PA 19131
Phone (866) 453-8800

4190 City Line Ave
Ste 315
Philadelphia, PA 19131
Phone (215) 871-6337

317 Chestnut St
Quarryville, PA 17566
Phone (717) 544-3555

Interoperability endpoints

  • Direct secure messaging: michael.srulevich@direct.pcom.nextgenshare.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1275670655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 JUNIPER RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835410",
            "telephone_number": "610-853-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1553 CHESTER PIKE",
            "address_2": "SUITE 201",
            "city": "CRUM LYNNE",
            "state": "PA",
            "postal_code": "190221022",
            "telephone_number": "610-499-7180",
            "fax_number": "610-499-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRULEVICH",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "OS012617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019420800003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crum Lynne, PA

Sources for this page

Verify at the official NPI Registry.