Active NPI
Ibrahim Shamasneh, M.D.
- Hospitalist Physician
- Saint Louis, MO
National Provider Identifier
1013604933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 2026030846
- Practice address
- 1201 S Grand Blvd
Saint Louis, MO 63104-1016 - Phone
- (314) 617-2000
- NPI assigned
- Apr 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Hospitalist Physician | 208M00000X | 2026030846 | MO | Primary |
Addresses
Primary practice location
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Mailing address
1270 Prince Ave
Suite 102
Athens, GA 30606
Other practice location 1
1270 Prince Ave
Suite 102
Athens, GA 30606
Phone (706) 475-7055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231206003878 | GA | Order and Referring Only - Internal Medicine | 7618326331 |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
150 Westpark Dr
Apt 1118
Athens, GA 30606-7502
PO Box
Saint Louis, MO 63195
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783555200000",
"number": "1013604933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1270 PRINCE AVE",
"address_2": "SUITE 102",
"city": "ATHENS",
"state": "GA",
"postal_code": "30606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041016",
"telephone_number": "314-617-2000"
}
],
"practiceLocations": [
{
"address_1": "1270 Prince Ave",
"address_2": "Suite 102",
"address_purpose": "LOCATION",
"city": "Athens",
"state": "GA",
"postal_code": "30606",
"country_code": "US",
"telephone_number": "706-475-7055",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAMASNEH",
"first_name": "IBRAHIM",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-20",
"last_updated": "2026-07-09",
"certification_date": "2026-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MO",
"license": "2026030846",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.