Individual provider Active NPI

Shabbir A Shaikh, MD

  • Internal Medicine Physician
  • Fairview Heights, IL
National Provider Identifier
1053337568
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036075000 Issued in IL
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, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
110076104OtherRAILROAD MEDICARE
036075000MedicaidIL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071102000160 IL Practitioner - Internal MedicinePractitioner - Pulmonary Disease 5294822532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
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

LicenseStateTypeSpecialty
036075000ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Goldenberg & Associates Internal Medicine CurrentSince Jan 1, 1987 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

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEGCDA/Endpoint/CEGCDA
  • Direct secure messaging: 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.

Hospital & facility affiliations 3

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": "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

Verify at the official NPI Registry.