Ronnie Shade Jr, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Abington, Pennsylvania. His current practice location is
1200 Old York Rd, Abington, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(215) 481-2606.
Ronnie Shade Jr is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1487394805.
Physician's Profile
Full Name | Ronnie Shade Jr |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1200 Old York Rd, Abington, Pennsylvania |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1487394805
- Provider Enumeration Date: 04/01/2022
- Last Update Date: 05/05/2025
Medicare PECOS Information:
- PECOS PAC ID: 4082001573
- Enrollment ID: I20220502002158
Medical Identifiers
Medical identifiers for Ronnie Shade Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487394805 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | OS024474 (Pennsylvania) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ronnie Shade Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ronnie Shade Jr, DO 2433 N 50th St, Philadelphia, PA 19131-1404 Ph: (214) 417-2500 | Ronnie Shade Jr, DO 1200 Old York Rd, Abington, PA 19001-3720 Ph: (215) 481-2606 |
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