Individual provider Active NPI

Michael Schaeffer, D.P.M.

  • Podiatrist
  • Philadelphia, PA
National Provider Identifier
1720114036
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC001458L Issued in PA
Practice address
4041 Lancaster Ave
Philadelphia, PA 19104-1753
Phone
(215) 843-3668
Fax
(215) 613-5298
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC001458L PA Primary
Foot & Ankle Surgery Podiatrist 213ES0103X SC001458L PA

Addresses

Primary practice location

4041 Lancaster Ave
Philadelphia, PA 19104-1753

Mailing address

4041 Lancaster Ave
Philadelphia, PA 19104-1753
Phone (215) 843-3668

Other identifiers 1

IdentifierTypeStateIssuer
0060704000OtherPAHIGHMARK BLUE SHIELD

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220112001830 PA Practitioner - Podiatry 4284041138 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
The Doctor Shop LLC CurrentSince Jun 2, 2020 Accepting new patients

Organizations & group practices 2

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1720114036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 LANCASTER AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191041753",
            "telephone_number": "215-843-3668",
            "fax_number": "215-613-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 LANCASTER AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191041753",
            "telephone_number": "215-843-3668",
            "fax_number": "215-613-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFFER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC001458L",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC001458L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "0060704000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.