MEDICARE: PRASHAMSA SHENOY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	MD481561	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1821865742	OTHER	PA	OTHER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1821865742	OTHER	DE	OTHER

General Provider Information

NPI Number	:	1821865742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRASHAMSA SHENOY MD

Provider Business Mailing Address
First Line	:	833 CHESTNUT ST STE 700
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4410
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	833 CHESTNUT ST STE 701
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4409
Country	:	US
Telephone Number	:	215-503-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2023
Last Update Date	:	05/14/2026

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