DR. MIRA B SHORE PSYD.
NPI 1750079067
Psychologist in Philadelphia, PA
About Dr. Mira B Shore Psyd. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MIRA B SHORE PSYD. (NPI 1750079067) is an individual psychologist in Philadelphia, Pennsylvania and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Sharon Hill, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Mira B Shore Psyd. 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.
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.
PHILADELPHIA, PA 19123
PHILADELPHIA, PA 19123
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 Mira Shore's NPI number?
The NPI number for Mira Shore is 1750079067. It was assigned to this individual provider in the NPPES registry on April 25, 2023.
Where is Mira Shore located?
Mira Shore practices at 850 N 11th St, Philadelphia, PA 19123. The listed phone number is (267) 597-3604.
What is Mira Shore's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Mira Shore enrolled in Medicare?
Yes. Mira Shore 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.
When was this NPI record last updated?
The NPPES record for Mira Shore was last updated on February 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.