NPIMap

Individual provider Active NPI

Bradly Scott Shollenberger, D.P.M.

  • Podiatrist
  • Reading, PA
National Provider Identifier
1366433591
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC002902L Issued in PA
Practice address
4885 Demoss Rd
Suite 103
Reading, PA 19606-9023
Phone
(610) 779-4020
Fax
(610) 776-7044
NPI assigned
Nov 5, 2005
Last updated
Nov 2, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC002902L PA Primary
Foot & Ankle Surgery Podiatrist 213ES0103X SC002902L PA

Addresses

Primary practice location

4885 Demoss Rd
Suite 103
Reading, PA 19606-9023

Mailing address

4885 Demoss Rd
Suite 103
Reading, PA 19606-9023
Phone (610) 779-4020

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
I20090428000285 PA Practitioner - Podiatry 8921058173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Berks Foot Specialists PCGroup PAC ID 6103806302, 2 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

4885 Demoss Rd
Suite 103
Reading, PA 19606-9024

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.74 of 100Reported as individual
Quality
73.3
Promoting interoperability
92
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue35
Removal of skin lesions1-10
Removal of nail tissue924
Removal or shaving of skin growth443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC002902LPAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Berks Foot Specialists, PC Podiatrist CurrentSince May 22, 1986 Accepting new patients
Tri-County Foot Foot & Ankle Surgery Past Accepting new patients

Locations

4885 Demoss Rd
Ste 103
Reading, PA 19606
Phone (215) 779-4020

Organizations & group practices 2

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 6

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": "1131148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1366433591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4885 DEMOSS RD",
            "address_2": "SUITE 103",
            "city": "READING",
            "state": "PA",
            "postal_code": "196069023",
            "telephone_number": "610-779-4020",
            "fax_number": "610-776-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4885 DEMOSS RD",
            "address_2": "SUITE 103",
            "city": "READING",
            "state": "PA",
            "postal_code": "196069023",
            "telephone_number": "610-779-4020",
            "fax_number": "610-776-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOLLENBERGER",
        "first_name": "BRADLY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-05",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC002902L",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC002902L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

Verify at the official NPI Registry.