Individual provider Active NPI

Shaun Novoshelski, DPM

  • Student in an Organized Health Care Education/Training Program
  • Philadelphia, PA
National Provider Identifier
1891365144
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
SC007201 Issued in PA
Practice address
10800 Knights Rd
Philadelphia, PA 19114-4200
Phone
(215) 612-5161
NPI assigned
Jun 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X SC007201 PA Primary

Addresses

Primary practice location

10800 Knights Rd
Philadelphia, PA 19114-4200

Mailing address

10800 Knights Rd
Philadelphia, PA 19114-4200

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
I20250130000165 PA Practitioner - Podiatry 0244769602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Orthopaedic and Sports Medicine Associates, LTDGroup PAC ID 5890681092, 218 clinicians

Practice addresses (Care Compare)

2004 Sproul Rd
FL 1
Broomall, PA 19008-3511
Phone (610) 353-0800

300 Springhouse Dr
Collegeville, PA 19426-4021
Phone (610) 489-4745

4 Industrial Blvd
Paoli, PA 19301-1605

491 John Young Way
Suite 210
Exton, PA 19341-2567
Phone (610) 524-7251

Hospital & facility affiliations

  • Paoli Hospital Hospital, Paoli, PA, CCN 390153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC007201PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedic and Sports Medicine Associates, LTD CurrentSince Jan 24, 2025 Accepting new patients
Premier Orthopaedic and Sports Medicine Associates LTD CurrentSince Jan 24, 2025 Accepting new patients
Orthopedic Sports & Arthritis Surgery Past Accepting new patients

Locations

2004 Sproul Rd
Fl 1
Broomall, PA 19008
Phone (610) 353-0800

266 Lancaster Ave
Ste 200
Malvern, PA 19355
Phone (610) 640-4133

4 Industrial Blvd
Ste 165
Paoli, PA 19301
Phone (610) 359-5640

Interoperability endpoints

  • Direct secure messaging: shaun.novoshelski.1@22724.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1891365144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOSHELSKI",
        "first_name": "SHAUN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "SC007201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.