Active NPI
Shabbir A Shaikh, MD
- Internal Medicine Physician
- Fairview Heights, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036075000
- Practice address
- 5003 N Illinois St Ste 2
Fairview Heights, IL 62208-3419 - Phone
- (618) 233-5000
- Fax
- (618) 233-5040
- NPI assigned
- Jul 15, 2006
- Last updated
- Oct 15, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036075000 | IL | Primary |
Addresses
Primary practice location
5003 N Illinois St Ste 2
Fairview Heights, IL 62208-3419
Mailing address
5003 N Illinois St Ste 2
Fairview Heights, IL 62208-3419
Phone (618) 233-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110076104 | Other | RAILROAD MEDICARE | |
| 036075000 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5003 N Illinois St
Suite 2
Fairview Heights, IL 62208-3419
Phone (618) 233-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036075000 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goldenberg & Associates | Internal Medicine | Current | Accepting new patients |
Locations
4600 Memorial Dr
Ste 20
Belleville, IL 62226
Phone (618) 233-5000
5003 N Illinois St
#2
Fairview Heights, IL 62208
Phone (618) 233-5000
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CEGCDA/Endpoint/CEGCDA
- shabbir.shaikh@gamsc.eclinicaldirectplus.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Fairview Heights, IL
- NPI 1679599104
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Memorial Hospital
- General Acute Care Hospital
- Belleville, IL
- NPI 1982796181
-
dba HSHS St. Elizabeth's Hospital
- General Acute Care Hospital
- O'Fallon, IL
- NPI 1629057302
-
- Community Based Hospice Care Agency
- Fairview Heights, IL
- NPI 1902134299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1053337568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5003 N ILLINOIS ST STE 2",
"city": "FAIRVIEW HEIGHTS",
"state": "IL",
"postal_code": "622083419",
"telephone_number": "618-233-5000",
"fax_number": "618-233-5040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5003 N ILLINOIS ST STE 2",
"city": "FAIRVIEW HEIGHTS",
"state": "IL",
"postal_code": "622083419",
"telephone_number": "618-233-5000",
"fax_number": "618-233-5040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAIKH",
"first_name": "SHABBIR",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2024-10-15",
"certification_date": "2024-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036075000",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110076104",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036075000",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fairview Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.