Individual provider Active NPI

James Michael Shettsline, DO

  • Family Medicine Physician
  • Lansdale, PA
National Provider Identifier
1922158849
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS004848L Issued in PA
Practice address
920 N Broad St Ste 6
Lansdale, PA 19446-2351
Phone
(610) 278-9741
Fax
(610) 272-0991
NPI assigned
Jan 11, 2007
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X OS004848L PA
Family Medicine Physician 207Q00000X OS004848L PA Primary

Addresses

Primary practice location

920 N Broad St Ste 6
Lansdale, PA 19446-2351

Mailing address

920 N Broad St Ste 6
Lansdale, PA 19446-2351
Phone (215) 855-4700

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
I20040922000686 PA Practitioner - Family Practice 3476521964 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS004848LPAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard H. Kaplan, M.D., P.C. CurrentSince Sep 11, 2023 Accepting new patients
Phoenixville Clinic Company LLC CurrentSince Jan 1, 2017 Accepting new patients
Phoenixville Clinic Company LLC CurrentSince Jan 1, 2017 Accepting new patients
Phoenixville Clinic Company LLC Family Medicine Current Accepting new patients
James Shettsline D.O. Family Practice Family Medicine Past Accepting new patients

Locations

1019 W Main St
Norristown, PA 19401
Phone (610) 272-6016

9140 Academy Rd
Ste A
Philadelphia, PA 19114
Phone (215) 331-6050

140 Nutt Rd
Phoenixville, PA 19460
Phone (610) 983-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1606/brand/1/csg/101/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1922158849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 N BROAD ST STE 6",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194462351",
            "telephone_number": "215-855-4700",
            "fax_number": "215-361-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 N BROAD ST STE 6",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194462351",
            "telephone_number": "610-278-9741",
            "fax_number": "610-272-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTSLINE",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "PA",
            "license": "OS004848L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS004848L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

Verify at the official NPI Registry.