Individual provider Active NPI

Julie Paige Shtraks, M.D.

  • Otolaryngology Physician
  • Philadelphia, PA
National Provider Identifier
1912313792
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD470607 Issued in PA
Practice address
205 N Broad St Ste 401
Philadelphia, PA 19107-1553
Phone
(215) 762-4600
Fax
(215) 988-0733
NPI assigned
Jul 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD470607 PA Primary

Addresses

Primary practice location

205 N Broad St Ste 401
Philadelphia, PA 19107-1553

Mailing address

2 Town PL Ste 110
Bryn Mawr, PA 19010-3420
Phone (610) 762-5666

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200630000262 PA Practitioner - Otolaryngology 6800218355 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University Otolaryngology Associates PC Otolaryngology CurrentSince Jul 1, 2020 Accepting new patients

Locations

8350 Roosevelt Blvd
Philadelphia, PA 19152
Phone (215) 331-6878

205 N Broad St
Ste 401
Philadelphia, PA 19107
Phone (215) 569-3155

Organizations & group practices 1

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": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1912313792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TOWN PL STE 110",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103420",
            "telephone_number": "610-762-5666",
            "fax_number": "484-380-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST STE 401",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071553",
            "telephone_number": "215-762-4600",
            "fax_number": "215-988-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHTRAKS",
        "first_name": "JULIE",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-01",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD470607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.