Individual provider Active NPI

Shelley J. Epstein, PA-C

  • Surgical Physician Assistant
  • Wynnewood, PA
National Provider Identifier
1528197241
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA050981 Issued in PA
Practice address
100 E Lancaster Ave
Suite 330 Mob West
Wynnewood, PA 19096-3450
Phone
(610) 645-9093
Fax
(610) 645-9476
NPI assigned
Mar 6, 2007
Last updated
Oct 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA050981 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
Suite 330 Mob West
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
Suite 330 Mob West
Wynnewood, PA 19096-3450
Phone (610) 645-9093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20081030000438 DE Practitioner - Physician Assistant 5799844148 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA050981PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Aug 19, 2015 Accepting new patients
Christiana Care Health Services Inc CurrentSince Aug 19, 2015 Accepting new patients
First State Orthopaedics, PA Past Accepting new patients
Main Line Healthcare PastSince Sep 1, 2006 Accepting new patients

Locations

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

Organizations & group practices 5

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 1

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1528197241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 330 MOB WEST",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-645-9093",
            "fax_number": "610-645-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 330 MOB WEST",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-645-9093",
            "fax_number": "610-645-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPSTEIN",
        "first_name": "SHELLEY",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA050981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.