Individual provider Active NPI

Umar Shad, MD

  • Family Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1043499049
Registry record updated Nov 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
52104-20 Issued in WI
Practice address
5800 W Burleigh St
Milwaukee, WI 53210-1516
Phone
(414) 444-7787
Fax
(414) 444-8803
NPI assigned
Oct 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 52104-20 WI Primary

Addresses

Primary practice location

5800 W Burleigh St
Milwaukee, WI 53210-1516

Mailing address

5800 W Burleigh St
Milwaukee, WI 53210-1516
Phone (414) 444-7787

Other identifiers 1

IdentifierTypeStateIssuer
1043499049MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20090811000290 WI Practitioner - Family Practice 3779637731 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Milwaukee Cardiac Care LLCGroup PAC ID 9133280670, 2 clinicians
Muslim Community and Health Center of Wisconsin Inc.Group PAC ID 7618258062, 17 clinicians

Practice addresses (Care Compare)

5434 W Capital Dr
Milwaukee, WI 53216-2298
Phone (414) 442-5400

803 W Layton Ave
Milwaukee, WI 53221-2426
Phone (414) 939-4411

Hospital & facility affiliations

  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Muslim Community and Health Center of Wisconsin Inc CurrentSince Aug 1, 2022 Accepting new patients
Milwaukee Cardiac Care LLC CurrentSince Oct 1, 2014 Accepting new patients
Comprehensive Podiatry Services CurrentSince Aug 1, 2022 Accepting new patients

Locations

5800 W Burleigh St
Milwaukee, WI 53210
Phone (414) 444-7787

5434 W Capitol Dr
Milwaukee, WI 53216
Phone (414) 442-5400

803 W Layton Ave
Milwaukee, WI 53221
Phone (414) 253-8330

7733 W Burleigh St
Milwaukee, WI 53222
Phone (262) 328-4232

5434 W Capitol Dr
Ste 1
Milwaukee, WI 53216
Phone (414) 251-3500

2603 W Rawson Ave
Ste 135
Oak Creek, WI 53154
Phone (414) 271-8181

Interoperability endpoints

  • Direct secure messaging: ushad724225@direct.ochin.org
  • Direct secure messaging: umar.shad.1@22338.direct.athenahealth.com

Organizations & group practices 3

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 2

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": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448496000000",
    "number": "1043499049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 W BURLEIGH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101516",
            "telephone_number": "414-444-7787",
            "fax_number": "414-444-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 W BURLEIGH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101516",
            "telephone_number": "414-444-7787",
            "fax_number": "414-444-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAD",
        "first_name": "UMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-26",
        "last_updated": "2015-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "52104-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043499049",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.