Individual provider Active NPI

Bushra Shaukat, MD

  • Hospitalist Physician
  • Belleville, IL
National Provider Identifier
1033486758
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036-134673 Issued in IL
Practice address
4500 Memorial Dr
Belleville, IL 62226
Phone
(618) 257-6220
Fax
(618) 257-6679
NPI assigned
Nov 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036-134673 IL Primary

Addresses

Primary practice location

4500 Memorial Dr
Belleville, IL 62226

Mailing address

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-6220

Other practice location 1

1200 N East St
Olney, IL 62450-2432
Phone (618) 392-2940

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140801000070 IL Practitioner - HospitalistPractitioner - Family Practice 0749406478
I20250630000858 MD Practitioner - Family Practice 0749406478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, 730 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-134673ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meritus Medical Center Inc Current Accepting new patients
Meritus Medical Center Inc CurrentSince Jul 7, 2025 Accepting new patients
Meritus Medical Center Inc CurrentSince Jul 7, 2025 Accepting new patients
Richland Memorial Hospital, Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Meritus Medical Center Inc Past Accepting new patients

Locations

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

Interoperability endpoints

  • Direct secure messaging: bshaukat1177588@meritus.direct-ci.net

Organizations & group practices 6

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": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1033486758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-257-6220",
            "fax_number": "618-257-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-257-6220",
            "fax_number": "618-257-6679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N East St",
            "address_purpose": "LOCATION",
            "city": "Olney",
            "state": "IL",
            "postal_code": "624502432",
            "country_code": "US",
            "telephone_number": "618-392-2940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAUKAT",
        "first_name": "BUSHRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036-134673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4500 Memorial Dr",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.