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Individual provider Active NPI

Shantel Lorraine Riedel Polchlopek, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1780928499
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056851 Issued in PA
Practice address
3400 Spruce Street
Ground Floor Donner
Philadelphia, PA 19104-4206
Phone
(215) 662-6698
Fax
(215) 662-3953
NPI assigned
Nov 19, 2012
Last updated
Sep 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA056851 PA Primary

Addresses

Primary practice location

3400 Spruce Street
Ground Floor Donner
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce Street
Ground Floor Donner
Philadelphia, PA 19104-4206
Phone (215) 662-6698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ, DE3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140711000602 PA Practitioner - Physician Assistant 7214152008 Reassigns benefits to 3 organizations
I20231017001016 NJ Practitioner - Physician Assistant 7214152008 Reassigns benefits to 1 organization
I20231017002083 DE Practitioner - Physician Assistant 7214152008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Telehealth LLCGroup PAC ID 6608156906, 43 clinicians

Practice addresses (Care Compare)

2004 Shipley Rd
Wilmington, DE 19803-5248
Phone (888) 982-8594

410 N Krocks Rd
Allentown, PA 18106-9283
Phone (888) 982-8594

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 24, 2016 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 24, 2016 Accepting new patients
BPS Medical of New Jersey, LLC Past Accepting new patients

Locations

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Organizations & group practices 8

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 10

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": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1780928499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "GROUND FLOOR DONNER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6698",
            "fax_number": "215-662-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "GROUND FLOOR DONNER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6698",
            "fax_number": "215-662-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLCHLOPEK",
        "first_name": "SHANTEL",
        "middle_name": "LORRAINE RIEDEL",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.