Individual provider Active NPI

Shervin Mirshahi, M.D.

  • Diagnostic Radiology Physician
  • Milwaukee, WI
National Provider Identifier
1063832335
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
82641 Issued in WI
Practice address
9200 W Wisconsin Avenue
Department of Radiology
Milwaukee, WI 53226-3522
Phone
(414) 805-2060
Fax
(414) 259-9290
NPI assigned
Apr 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 282835 MA
Diagnostic Radiology Physician 2085R0202X 82641 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Avenue
Department of Radiology
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Avenue
Department of Radiology
Milwaukee, WI 53226-3522
Phone (414) 805-2060

Other practice location 1

4455 S 108th St
Greenfield, WI 53228-2504
Phone (414) 427-5310

Other practice location 2

11421 N Port Washington Road
Mequon, WI 53092-0990
Phone (262) 518-4910

Other practice location 3

W180N8085 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 257-3060

Other practice location 4

3522 W Lisbon Ave
Milwaukee, WI 53208-1953
Phone (414) 935-8000

Other practice location 5

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-5533

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
I20231005000355 WI Practitioner - Diagnostic Radiology 8628298395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

2315 E Moreland Blvd
Waukesha, WI 53186-2939
Phone (262) 532-5700

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051-4002
Phone (262) 255-2500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
282835MAMDDiagnostic Radiology Physician
82641WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Surgery CurrentSince Sep 15, 2023 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 17, 2023 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 17, 2023 Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051
Phone (262) 255-2500

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

11421 N Port Washington Rd
Mequon, WI 53092
Phone (262) 518-4910

4455 S 108th St
Milwaukee, WI 53228
Phone (414) 409-7593

3522 W Lisbon Ave
Milwaukee, WI 53208
Phone (414) 935-8000

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Interoperability endpoints

  • Direct secure messaging: smirshahi121646@direct.chw.org
  • Direct secure messaging: smirshahi688247@direct.froedtert.com

Organizations & group practices 4

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": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1063832335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVENUE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-2060",
            "fax_number": "414-259-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVENUE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-2060",
            "fax_number": "414-259-9290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4455 S 108th St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532282504",
            "country_code": "US",
            "telephone_number": "414-427-5310",
            "fax_number": "414-427-5311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11421 N Port Washington Road",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530920990",
            "country_code": "US",
            "telephone_number": "262-518-4910",
            "fax_number": "262-518-4911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W180N8085 Town Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530513518",
            "country_code": "US",
            "telephone_number": "262-257-3060",
            "fax_number": "262-518-5052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3522 W Lisbon Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532081953",
            "country_code": "US",
            "telephone_number": "414-935-8000",
            "fax_number": "414-454-4995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530959274",
            "country_code": "US",
            "telephone_number": "262-836-5533",
            "fax_number": "262-836-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRSHAHI",
        "first_name": "SHERVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-24",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "282835",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "82641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.