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JONATHAN SHACK MD
NPI 1629066626
Psychiatry & Neurology - Psychiatry in Philadelphia, PA

Active since October 12, 2005PECOS EnrolledAccepts Medicare Assignment
100 E LEHIGH AVE, MAB BLDG STE 105, PHILADELPHIA, PA 19125(215) 707-8496(215) 707-4086 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jonathan Shack Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN SHACK MD (NPI 1629066626) is an individual psychiatry provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD045140L) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1989).

NPPES Registry Identity

NPI1629066626
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameJONATHAN SHACKCredential: MD
Location Address100 E LEHIGH AVE, MAB BLDG STE 105Philadelphia, PA 19125-1000
Mailing Address3425 N Carlisle St, 2nd Floor Hudson BldgPhiladelphia, PA 19140-5108 · (215) 707-4739 · Fax (215) 707-3677
Phone(215) 707-8496
Fax(215) 707-4086
Sole ProprietorNo
Medical School CMSOtherGraduated 1989
Enumeration DateOctober 12, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1629066626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in PA · MD045140L
Definition
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.
100 E LEHIGH AVE, Philadelphia, PA 19125
Open in Google Maps ↗

Other Identifiers 1

Medicaid0013992500004PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jonathan Shack Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5092608265
PECOS Enrollment IDI20040203000756
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jonathan Shack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Eastern Pennsylvania Physician Alliance LLC
239 mi
Neurology
2 HOSPITAL DR
Clarion, PA 16214
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 142 clinicians in this Medicare group
NPI 1902440621 (814) 226-9545

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
927 services46 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
54 services30 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
16 services16 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
15 services15 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
12 services12 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19125 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$180.99 typical visit price
range $59.88 – $180.99
Typical copayment $45.24 (range $14.97 – $45.24)
Most-billed visit code 99205
Established Patient
$74.47 typical visit price
range $19.30 – $147.29
Typical copayment $18.61 (range $4.82 – $36.82)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBERT ERIC SIMONS
Psychiatry & Neurology (Psychiatry)
100 E LEHIGH AVE
PHILADELPHIA, PA 19125
Philadelphia County (215) 707-1200
EILEEN ZHOU MD
Psychiatry & Neurology (Psychiatry)
100 E LEHIGH AVE
PHILADELPHIA, PA 19125
Philadelphia County (215) 707-1200
MADHULATHA PAUL MD
Psychiatry & Neurology (Psychiatry)
100 E LEHIGH AVE, MAB BLDG STE 105
PHILADELPHIA, PA 19125
Philadelphia County (215) 707-8496
HARGROW DEXTER BARBER DDS
Dentist (Oral and Maxillofacial Surgery)
100 E LEHIGH AVE
PHILADELPHIA, PA 19125
Philadelphia County (215) 707-3613
GABRIEL SANCHEZ-ALDANA JR. M.D.
Family Medicine
100 E LEHIGH AVE
PHILADELPHIA, PA 19125
Philadelphia County (215) 707-1866
TEMPLE PHYSICIANS INC.
Internal Medicine
100 E LEHIGH AVE, CHC - 1
PHILADELPHIA, PA 19125
Philadelphia County (215) 707-1866
TEMPLE PHYSICIANS INC.
Internal Medicine (Cardiovascular Disease)
100 E LEHIGH AVE, MAB 110
PHILADELPHIA, PA 19125
Philadelphia County (215) 707-1136
DR. RUBY HASSANYEH BARGHINI M.D.
Psychiatry & Neurology (Psychiatry)
100 E LEHIGH AVE
PHILADELPHIA, PA 19125
Philadelphia County (215) 707-8496

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Shack's NPI number?

The NPI number for Jonathan Shack is 1629066626. It was assigned to this individual provider in the NPPES registry on October 12, 2005.

Where is Jonathan Shack located?

Jonathan Shack practices at 100 E Lehigh Ave Mab Bldg Ste 105, Philadelphia, PA 19125. The listed phone number is (215) 707-8496.

What is Jonathan Shack's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Jonathan Shack enrolled in Medicare?

Yes. Jonathan Shack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jonathan Shack's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Shack reassigns Medicare benefits to Eastern Pennsylvania Physician Alliance LLC (Clarion, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jonathan Shack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jonathan Shack accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Jonathan Shack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jonathan Shack was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.