Philip Shrake, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

46327 Issued in GA

Practice address

311 Philip Blvd
Lawrenceville, GA 30045-8733

Phone

(770) 995-3000

Fax

(770) 995-1427

NPI assigned

Dec 1, 2005

Last updated

Oct 1, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Specialty

Radiation Oncology

Education

Indiana University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

Merit-based Incentive Payment System (MIPS)

Final score

98.79 of 100Reported as group

Quality

98.74

Improvement activities

40

Cost

83.11

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• North Atlanta Professional Services LLC

  • Psychologist
  • Atlanta, GA
  • NPI 1316959869

  Radiation Oncology

  Medicare reassignment Care Compare group NPD
• Radiotherapy Clinics of Georgia,LLC

  • Specialist
  • Decatur, GA
  • NPI 1851449540
  Medicare reassignment NPD
• Frank a Critz,MD

  • Specialist
  • Decatur, GA
  • NPI 1235184177
  NPD (past)

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

• Northside Hospital, Inc.

  dba Northside Hospital Forsyth

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1376527531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 116470",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303680001",
            "telephone_number": "770-682-2080",
            "fax_number": "678-579-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PHILIP BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300458733",
            "telephone_number": "770-995-3000",
            "fax_number": "770-995-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRAKE",
        "first_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "046327",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "GA",
            "license": "46327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00809729A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000809729D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Anthony Shore, M.D.
• Lewaa Shoujaa, MD
• Michelle R Shoultz, PA-C
• Connie Hall Shrake, M.D.
• Kevin Shrake, MD
• Christopher Shriver
• Kenneth Shults Jr., R.N.
• Taryn Shumaker, CSFA
• Muhammad Kamran Siddiq, DO
• Waqar Ahmed Siddiqui

• Radiation Oncology Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Radiation Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.

Verify at the official NPI Registry.