McShane Sports Medicine

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

MD055461L Issued in PA

Legal business name

MCSHANE SPORTS MEDICINE

Practice address

734 E Lancaster Ave
Villanova, PA 19085-1325

Phone

(610) 254-8001

Fax

(610) 254-0911

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John M McShane, M.D.NPI 1932216637

Title

President

Phone

(610) 254-8001

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Tax ID family

McShane Sports Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• McShane Sports Medicine PC

  • Podiatrist
  • Villanova, PA
  • NPI 1063557866
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John M McShane, MD

  • Sports Medicine (Family Medicine) Physician
  • Villanova, PA
  • NPI 1932216637
  Medicare reassignment NPD Authorized official
• Michael J Graveley, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Jenkintown, PA
  • NPI 1558351668
  NPD (past)
• Christopher Jon Mehallo, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1730103706
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831143361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 E LANCASTER AVE",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851325",
            "telephone_number": "610-254-8001",
            "fax_number": "610-254-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 E LANCASTER AVE",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851325",
            "telephone_number": "610-254-8001",
            "fax_number": "610-254-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCSHANE SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCSHANE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-254-8001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "MD055461L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stewart William McCallum, M.D.
• John B. McDay, M.D.
• Mary McGonigle, D.O.
• Spencer Lewiston McIntosh, LAT, ATC
• Sarah McNabb, OTD, MED, OTR/L
• McShane Sports Medicine PC
• John M McShane, MD
• Medrite Medical Care PC
• Jill Marie Melsha, D.C.
• Matthew Mitchell, ATC

• Sports Medicine (Family Medicine) Physician in Villanova, PA
• Providers in Villanova, PA by specialty
• Sports Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.