PHILIP S SHORE (MD) – Family Medicine Physician, NPI 1295750529

PHILIP S SHORE (MD) is a healthcare provider. based in Northridge, California. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. G071824 (CA). The NPI Number for PHILIP S SHORE (MD) is 1295750529

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
PHILIP S SHORE (MD)
NPI
1295750529
Phone
(818) 886-1100
Address
18546 ROSCOE BLVD
Enumeration Date
13 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
8188861100
Graduation Year
1990 (36 years ago)
PAC ID
0749178226
Group Practice PAC ID
7618005166
Professional Enrollment ID
I20040306000308
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for PHILIP S SHORE (MD)

  • Northridge Hospital Medical Center, 18300, Roscoe Boulevard, Reseda, Los Angeles, Los Angeles County, California, 91328, United States

    SUITE 230

    NORTHRIDGE, CA 913244663

    Phone: (818) 886-1100

    Fax: (818) 886-7501

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-03-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040306000308IFamily PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91324)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7618005166View full group profile

Reviews

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Frequently asked questions

Is PHILIP S SHORE (MD) listed with a National Provider Identifier?
Yes — PHILIP S SHORE (MD) has NPI 1295750529 on file in the registry.
Is PHILIP S SHORE (MD) shown as active in public data?
Registry records indicate PHILIP S SHORE (MD) maintains an active NPI.
What kind of doctor is PHILIP S SHORE (MD)?
PHILIP S SHORE (MD) is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is PHILIP S SHORE (MD) located near Northridge?
PHILIP S SHORE (MD) currently maps to Northridge, California in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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