Christopher Shaw
Individual provider Active NPI Physical Therapist · Drexel Hill, PA
NPI 1982287751 · NPPES record last updated Mar 2, 2022
Key facts
- NPI
- 1982287751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 1230 Burmont Rd
Drexel Hill, PA 19026-4504 - Phone
- (610) 449-1175
- Fax
- (610) 449-1195
- NPI assigned
- Apr 29, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Optimal Home Rehab, LLC
Practice addresses (Care Compare)
Philadelphia, PA 19131
Phone (267) 225-7775
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211108000969 | PA | Practitioner - Physical Therapist in Private Practice | 5092104307 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT005244L | PA | MD | Cardiopulmonary Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | PT005244L | PA | |
| Cardiopulmonary Physical Therapist | 2251C2600X | PT005244L | PA | |
| Geriatric Physical Therapist | 2251G0304X | PT005244L | PA | |
| Orthopedic Physical Therapist | 2251X0800X | PT005244L | PA | |
| Rehabilitation Practitioner | 225400000X | PT005244L | PA | |
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
1230 Burmont Rd
Drexel Hill, PA 19026-4504
Mailing address
1230 Burmont Rd
Drexel Hill, PA 19026-4504
Phone (610) 449-1175
Other providers in Drexel Hill, PA
- Shadeland Pharmacy LLC
- Ranjit R Shah
- Joyce E Shappell
- Talia Lynn Sharkey
- Rohit Sharma
- Roland E Shelton Jr.
- Rosemary Johanna Shields
- Sabura Shiffrin
- Wan S Shim
- Taraya J Shirdan
All providers in Drexel Hill, PA · Physical Therapist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.