NPIMap

Individual provider Active NPI

Winston Weidak Shu, MD

  • Nephrology Physician
  • Glenside, PA
National Provider Identifier
1922186345
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD428525 Issued in PA
Practice address
715 N Tyson Ave
Glenside, PA 19038
Phone
(215) 517-7171
NPI assigned
Nov 2, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD428525 PA
Nephrology Physician 207RN0300X MD428525 PA Primary

Addresses

Primary practice location

715 N Tyson Ave
Glenside, PA 19038

Mailing address

715 N Tyson Ave
Glenside, PA 19038-3845
Phone (215) 517-7171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070223000259 PA Practitioner - NephrologyPractitioner - Internal Medicine 6305948290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hypertension Nephrology Associates PCGroup PAC ID 6103809967, 17 clinicians

Practice addresses (Care Compare)

735 Fitzwatertown Rd
Suite 1
Willow Grove, PA 19090-1338
Phone (215) 657-2012

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amh Medical Staff Service Fund Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Hypertension Nephrology Associates, PC Nephrology CurrentSince Jul 1, 2018 Accepting new patients
Oncall Physician Staffing, Inc Past Accepting new patients
Oncall Hospitalist Staffing, PC Past Accepting new patients

Locations

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

2510 Maryland Rd
Ste 200
Willow Grove, PA 19090

735 Fitzwatertown Rd
Willow Grove, PA 19090
Phone (215) 657-2012

735 Fitzwatertown Rd
Ste 1
Willow Grove, PA 19090
Phone (215) 657-2012

Organizations & group practices 4

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1922186345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N TYSON AVE",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190383845",
            "telephone_number": "215-517-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N TYSON AVE",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "19038",
            "telephone_number": "215-517-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHU",
        "first_name": "WINSTON",
        "middle_name": "WEIDAK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD428525",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD428525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenside, PA

Sources for this page

Verify at the official NPI Registry.