Individual provider Active NPI

Shire Jama, M.D.

  • Internal Medicine Physician
  • Mankato, MN
National Provider Identifier
1033773007
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
71737 Issued in MN
Practice address
1025 Marsh St
Mankato, MN 56001-4752
Phone
(507) 625-4031
NPI assigned
Apr 25, 2019
Reactivated
Dec 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Internal Medicine Physician 207R00000X 71737 MN Primary

Addresses

Primary practice location

1025 Marsh St
Mankato, MN 56001-4752

Mailing address

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

Other practice location 1

506 Lenox Avenue
New York, NY 10037
Phone (212) 939-1406

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjama1784093@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20220815002407 MN Practitioner - Internal Medicine 3274916887 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, shared by 6 NPIs, 658 clinicians

Practice addresses (Care Compare)

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71737MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-St James Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 1, 2024 Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Aug 1, 2022 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Jan 1, 2024 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Aug 1, 2022 Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 1, 2024 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Aug 1, 2022 Accepting new patients
Mayo Clinic Health System-St James CurrentSince Mar 31, 2023 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Past Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351

32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261

Organizations & group practices 13

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.

View all 13

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": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1033773007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 Lenox Avenue",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10037",
            "country_code": "US",
            "telephone_number": "212-939-1406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMA",
        "first_name": "SHIRE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-25",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "deactivation_date": "2019-11-22",
        "reactivation_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "71737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjama1784093@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1025 Marsh St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560014752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.