Individual provider Active NPI

Robert S Shusman, MD

  • Family Medicine Physician
  • Springfield, PA
National Provider Identifier
1609873991
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD027134E Issued in PA
Practice address
9 N Brookside Rd
Springfield, PA 19064-2527
Phone
(610) 543-5300
Fax
(610) 543-3124
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD027134E PA Primary

Addresses

Primary practice location

9 N Brookside Rd
Springfield, PA 19064-2527

Mailing address

450 Park Way
Suite 300
Broomall, PA 19008-4202
Phone (484) 422-8080

Other identifiers 1

IdentifierTypeStateIssuer
0013981050003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20100621000555 PA Practitioner - Family Practice 8820129711 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD027134EPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penn Medicine-Pma CurrentSince Jan 25, 2022 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Family Medicine CurrentSince Jun 16, 2022 Accepting new patients
Penn Medicine-Pma CurrentSince Jan 25, 2022 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jun 16, 2022 Accepting new patients

Locations

150 Monument Rd
Ste 400
Bala Cynwyd, PA 19004
Phone (610) 747-3470

301 W Chester Pike
Ste 201
Havertown, PA 19083
Phone (610) 853-2900

9 N Brookside Rd
Springfield, PA 19064
Phone (610) 543-5300

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Interoperability endpoints

  • FHIR API: https://ssproxy.pennhealth.com/PRD-FHIR/api/FHIR/R4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1609873991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 PARK WAY",
            "address_2": "SUITE 300",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190084202",
            "telephone_number": "484-422-8080",
            "fax_number": "484-422-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 N BROOKSIDE RD",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642527",
            "telephone_number": "610-543-5300",
            "fax_number": "610-543-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUSMAN",
        "first_name": "ROBERT",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD027134E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0013981050003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

Verify at the official NPI Registry.