Active NPI
Shanna Danielle Raphael, PA
- Physician Assistant
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 5601 Loch Raven Blvd
Baltimore, MD 21239-2945 - Phone
- (443) 834-4351
- NPI assigned
- May 2, 2019
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
5601 Loch Raven Blvd
Baltimore, MD 21239-2945
Mailing address
2079 Misty Meadow Rd
Finksburg, MD 21048-1742
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440
5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (410) 581-1200
5601 Loch Raven Blvd Russel
Ste2
Baltimore, MD 21239-2945
Phone (443) 444-5600
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.34 of 100
- Quality
- 67.9
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 69.47
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Medical Group II LLC | Current | Accepting new patients |
Locations
5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714
1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440
Organizations & group practices 1
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.
-
- General Practice Physician
- Baltimore, MD
- NPI 1184046187
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba MedStar Good Samaritan
- General Acute Care Hospital
- Baltimore, MD
- NPI 1811084718
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601251200000",
"number": "1336704675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2079 MISTY MEADOW RD",
"city": "FINKSBURG",
"state": "MD",
"postal_code": "210481742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5601 LOCH RAVEN BLVD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212392945",
"telephone_number": "443-834-4351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAPHAEL",
"first_name": "SHANNA",
"middle_name": "DANIELLE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-02",
"last_updated": "2020-09-28",
"certification_date": "2020-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.