Individual provider Active NPI

Samir Shaath, M.D.

  • Obstetrics & Gynecology Physician
  • Dodge City, KS
National Provider Identifier
1023099686
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0425146 Issued in KS
Practice address
2020 Central Ave
Dodge City, KS 67801
Phone
(620) 227-1371
Fax
(620) 227-1208
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0425146 KS Primary

Addresses

Primary practice location

2020 Central Ave
Dodge City, KS 67801

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7782

Other practice location 1

310 E Walnut St
Garden City, KS 67846-5572
Phone (620) 275-9752

Other identifiers 1

IdentifierTypeStateIssuer
100158640AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20050505000197 KS Practitioner - Obstetrics/Gynecology 1850331265 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 W Ross BLV
Suite 2a
Dodge City, KS 67801-7217

Hospital & facility affiliations

  • Centura St. Catherine-Dodge City Hospital, Dodge City, KS, CCN 170175

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0425146KSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hodgeman County Health Center Current Accepting new patients
Hodgeman County Health Center CurrentSince Aug 3, 2022 Accepting new patients
Minneola District Hospital NBR 2 CurrentSince Aug 1, 2022 Accepting new patients
Minneola District Hospital NBR 2 Current Accepting new patients
Minneola District Hospital NBR 2 CurrentSince Aug 1, 2022 Accepting new patients
Hodgeman County Health Center CurrentSince Aug 3, 2022 Accepting new patients
Minneola District Hospital NBR 2 Current Accepting new patients
Commonspirit Kansas, Inc. Past Accepting new patients

Locations

2200 Summerlon Cir
Ste A
Dodge City, KS 67801
Phone (620) 371-7300

810 W Bramley St
Jetmore, KS 67854
Phone (620) 357-8354

809 W Bramley St
Jetmore, KS 67854
Phone (316) 357-8354

222 Main St
#97
Minneola, KS 67865
Phone (316) 885-4202

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15770/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1023099686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7782",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CENTRAL AVE",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "67801",
            "telephone_number": "620-227-1371",
            "fax_number": "620-227-1208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 E Walnut St",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "KS",
            "postal_code": "678465572",
            "country_code": "US",
            "telephone_number": "620-275-9752",
            "fax_number": "620-275-4306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAATH",
        "first_name": "SAMIR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KS",
            "license": "0425146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100158640A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

Verify at the official NPI Registry.