Individual provider Active NPI

Rachid Shimou

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1508641747
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00895000 Issued in NJ
Practice address
600 S 43Rd St
Philadelphia, PA 19104-4418
Phone
(610) 660-1000
NPI assigned
Aug 28, 2023
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00895000 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

600 S 43Rd St
Philadelphia, PA 19104-4418

Mailing address

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250129000387 NJ Practitioner - Physician Assistant 8921537408 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert Wood Johnson Physician EnterpriseGroup PAC ID 5597917633, 71 clinicians

Practice addresses (Care Compare)

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928

125 Paterson St
New Brunswick, NJ 08901-1962

901 W Main St
Suite 205
Freehold, NJ 07728-2537
Phone (732) 866-0800

Rutgers Health-RWJ Neurosurgery
Suite 2200
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Dec 2, 2024 Accepting new patients
Robert Wood Johnson Physician Enterprise Physician Assistant CurrentSince Mar 3, 2026 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Dec 2, 2024 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty Past Accepting new patients

Locations

901 W Main St
Ste 205
Freehold, NJ 07728
Phone (732) 866-0800

1 Robert Wood Johnson Pl
#2200
New Brunswick, NJ 08901

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

Organizations & group practices 6

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": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1508641747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-828-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S 43RD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044418",
            "telephone_number": "610-660-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMOU",
        "first_name": "RACHID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00895000",
            "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 Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.