Individual provider Active NPI

Shahid Jamil, M.D.

  • Psychiatry Physician
  • Pontiac, MI
National Provider Identifier
1003988817
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301041497 Issued in MI
Practice address
44555 Woodward Ave
Ste 405
Pontiac, MI 48341-5036
Phone
(248) 333-7100
Fax
(248) 858-7224
NPI assigned
Nov 15, 2006
Last updated
Jan 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301041497 MI Primary

Addresses

Primary practice location

44555 Woodward Ave
Ste 405
Pontiac, MI 48341-5036

Mailing address

44038 Woodward Ave
Suite 202
Bloomfield Hills, MI 48302-5035
Phone (248) 333-7100

Other identifiers 1

IdentifierTypeStateIssuer
1371228MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050719000157 MI Practitioner - Psychiatry 5496782872 Practice locations: Bloomfield Hills, MI

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2520 S Telegraph Rd
FL 2
Bloomfield Hills, MI 48302-0285
Phone (248) 333-7100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301041497MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Psychiatric Associates PC Psychiatry PastSince Jan 1, 2005 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sjamil41007@direct.trinity-health.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1003988817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44038 WOODWARD AVE",
            "address_2": "SUITE 202",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025035",
            "telephone_number": "248-333-7100",
            "fax_number": "248-858-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE",
            "address_2": "STE 405",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415036",
            "telephone_number": "248-333-7100",
            "fax_number": "248-858-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMIL",
        "first_name": "SHAHID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301041497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1371228",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.