NPI Details
Jonathan Shack, MD is a psychiatry psychiatry neurology in Philadelphia, PA with 36 years of experience. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. Jonathan Shack, MD NPI is 1629066626. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
100 E LEHIGH AVE
MAB BLDG STE 105
PHILADELPHIA, PA
ZIP 19125-000
Phone: (215) 707-8496
Fax: (215) 707-4086
The NPI 1629066626 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.
- Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
- Follow-up hospital inpatient care per day, typically 15 minutes (HCPCS:99231)
- Hospital discharge day management, more than 30 minutes (HCPCS:99239)
The enumeration date for this NPI number is 10/12/2005 and was last updated on 7/8/2007.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 2084P0800X | Psychiatry & Neurology | Psychiatry | MD045140L | PENNSYLVANIA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 501014 | MEDICARE ID-TYPE UNSPECIFIED | | |
| 2 | F50062 | MEDICARE UPIN | | |
| 3 | 0013992500004 | MEDICAID | PENNSYLVANIA | |
