Individual provider Active NPI

Michael Monir Shalaby, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1912369919
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD485444 Issued in PA
Practice address
3400 Spruce Street
Ground Silverstein BLDG
Philadelphia, PA 19104-4206
Phone
(504) 417-0249
NPI assigned
Mar 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD485444 PA Primary

Addresses

Primary practice location

3400 Spruce Street
Ground Silverstein BLDG
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce Street
GRD Ravdin
Philadelphia, PA 19104
Phone (504) 417-0249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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

Enrollment IDStateProvider typePAC IDDetails
I20200811000580 PA Practitioner - Emergency Medicine 0244655009 Reassigns benefits to 2 organizations
I20260605000479 NJ Practitioner - Emergency Medicine 0244655009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1000 River Rd
Suite 100
Conshohocken, PA 19428-2439

120 Crescent Hollow Dr
Sewell, NJ 08080-9656

Hospital & facility affiliations

  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Services of Pennsylvania, P.C. Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2024 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Organizations & group practices 7

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 3

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1912369919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "GRD RAVDIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "504-417-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "GROUND SILVERSTEIN BLDG",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "504-417-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALABY",
        "first_name": "MICHAEL",
        "middle_name": "MONIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD485444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.