Shilpa Samudrala, D.O.

Primary specialty

Vascular Neurology PhysicianTaxonomy code 2084V0102X

License

OS020588 Issued in PA

Practice address

255 W Lancaster Avenue
Suite 232 Mob 3
Paoli, PA 19301-1756

Phone

(484) 527-2229

Fax

(484) 527-0155

NPI assigned

Jun 24, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, PA2 enrollments

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 2

Specialty

Neurology

Education

Rowan University School of Osteopathic Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Paoli Hospital Hospital, Paoli, PA, CCN 390153
• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643

  Neurology

  Medicare reassignment Care Compare group NPD
• Providence Health & Services- Washington

  dba PMG NW Wa

  • General Practice Physician
  • Everett, WA
  • NPI 1124270715
  Medicare reassignment Care Compare group NPD
• Providence Health & Services- Washington

  dba PMG NW WA Mill Creek Commons

  • Family Medicine Physician
  • Mill Creek, WA
  • NPI 1790014504
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Main Line Hospitals, Inc.

  dba Paoli Hospital

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Providence Health & Services-Wa

  dba Providence Regional Medical Center Everett

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767398400000",
    "number": "1881045433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-527-2229",
            "fax_number": "484-527-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVENUE",
            "address_2": "SUITE 232 MOB 3",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011756",
            "telephone_number": "484-527-2229",
            "fax_number": "484-527-0155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 13th St",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982011689",
            "country_code": "US",
            "telephone_number": "425-297-5286",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3401 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405103",
            "country_code": "US",
            "telephone_number": "215-707-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUDRALA",
        "first_name": "SHILPA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2026-01-03",
        "certification_date": "2026-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "MA",
            "license": "63293",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "63293",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT017292",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "PA",
            "license": "OS020588",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "OP61170867",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• S. Wyn Brown, LLC
• Kathleen Sacharian, MSN, CRNP
• David Allan Sacks
• Tracie M Safier, MD
• Gabrielle Salinas
• Samuel H Galib - Opthamology Assoc PC
• Donald G Samuelson, MD
• Ellen Santella
• Kaviya Sathyakumar, MD
• Sudhakar R Satti, MD

• Vascular Neurology Physician in Paoli, PA
• Providers in Paoli, PA by specialty
• Vascular Neurology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.