NPIMap

Individual provider Active NPI

Shibu Mathew Philips, M.D., M.P.H.

  • Nuclear Imaging & Therapy Physician
  • Wilkes Barre, PA
National Provider Identifier
1427225911
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Imaging & Therapy PhysicianTaxonomy code 207UN0902X
License
MD443642 Issued in PA
Practice address
1000 East Mountain Blvd.
Wilkes-Barre, PA 18711-3446
Phone
(570) 808-7779
NPI assigned
May 13, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X MD443642 PA
Nuclear Imaging & Therapy Physician 207UN0902X MD443642 PA Primary
Diagnostic Radiology Physician 2085R0202X MD443642 PA

Addresses

Primary practice location

1000 East Mountain Blvd.
Wilkes-Barre, PA 18711-3446

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other practice location 1

1255 S Cedar Crest Blvd
Allentown, PA 18103-6256
Phone (610) 770-1606

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
I20110815000814 PA Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 6800911074 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Geisinger-HM Joint Venture LLCGroup PAC ID 1355676370, 426 clinicians

Practice addresses (Care Compare)

1000 E Mountain Dr
Wilkes Barre, PA 18711-0001
Phone (570) 826-7850

1824 E 3Rd St
Williamsport, PA 17701-3914
Phone (570) 601-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD443642PAMDNuclear Imaging & Therapy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 14, 2017 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Sep 24, 2019 Accepting new patients
Medical Imaging of Lehigh Valley PC Diagnostic Radiology CurrentSince Jan 15, 2014 Accepting new patients
Geisinger-HM Joint Venture, LLC Diagnostic Radiology Current Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 14, 2017 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Sep 24, 2019 Accepting new patients
Regional Imaging & Therapeutic Radiology Services PC Nuclear Medicine Past Accepting new patients
Geisinger Clinic Past Accepting new patients
Ny Downtown Hospital Radiology Faculty Practice Past Accepting new patients

Locations (25 of 31)

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

1255 S Cedar Crest Blvd
Allentown, PA 18103
Phone (610) 437-4800

226 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

410 Glen Ave
Bloomsburg, PA 17815
Phone (570) 416-1026

549 Fair St
Bloomsburg, PA 17815
Phone (570) 387-2100

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

100 N Academy Ave
Danville, PA 17822

35 Justin Dr
Danville, PA 17821
Phone (570) 271-6028

700 Hawk Ridge Dr
Hamburg, PA 19526
Phone (610) 562-0170

1020 Thompson St
Jersey Shore, PA 17740
Phone (570) 398-0100

311 4th St
Lewistown, PA 17044
Phone (717) 242-7600

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

68 Spring St
Lock Haven, PA 17745
Phone (570) 263-5830

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

5 Lakeview Dr
Moosic, PA 18507
Phone (570) 558-2180

10990 State Route 61
Mount Carmel, PA 17851
Phone (570) 339-4513

128 E Main St
Nanticoke, PA 18634
Phone (570) 258-1304

1201 Oak St
Pittston, PA 18640
Phone (570) 808-9800

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

5 Morgan Hwy
Ste 7
Scranton, PA 18508
Phone (570) 342-7864

531 Mt Pleasant Dr
Scranton, PA 18503
Phone (570) 342-8500

703 Martin F Gibbons Blvd
Scranton, PA 18519
Phone (570) 846-2340

30 Baldwin Blvd
Shamokin Dam, PA 17876
Phone (570) 884-7970

809 Hunter Hwy
Tunkhannock, PA 18657
Phone (570) 966-2700

Organizations & group practices 10

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 67

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

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1427225911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EAST MOUNTAIN BLVD.",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "187113446",
            "telephone_number": "570-808-7779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 S Cedar Crest Blvd",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036256",
            "country_code": "US",
            "telephone_number": "610-770-1606",
            "fax_number": "610-740-0560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILIPS",
        "first_name": "SHIBU",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "PA",
            "license": "MD443642",
            "primary": false
        },
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "PA",
            "license": "MD443642",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD443642",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.