Individual provider Active NPI

Corey Justin Shamah, M.D.

  • Hematology & Oncology Physician
  • Milwaukee, WI
National Provider Identifier
1104910249
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
45708020 Issued in WI
Practice address
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone
(414) 352-3100
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 45708020 WI Primary

Addresses

Primary practice location

3003 W Good Hope Rd
Milwaukee, WI 53209-2042

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (414) 352-3100

Other identifiers 2

IdentifierTypeStateIssuer
34771800MedicaidWI
P00474684OtherWIRR MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cshamah620@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20070706000156 WI Practitioner - Hematology/Oncology 2668572546 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Medical College of Wisconsin, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians
Aurora Health Care Metro, Inc.Group PAC ID 8628986536, 75 clinicians

Practice addresses (Care Compare)

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-5800

Hospital & facility affiliations

  • Aurora at Home Hospice, Wauwatosa, WI, CCN 521528
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207
  • Aurora Medical Ctr Washington County Hospital, Hartford, WI, CCN 520038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45708020WIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince Jan 1, 2008 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jan 1, 2008 Accepting new patients
Aurora Health Care Metro, Inc. Hematology & Oncology CurrentSince Dec 18, 2011 Accepting new patients
Baycare Aurora, LLC CurrentSince Jun 20, 2016 Accepting new patients
Advanced Healthcare SC Hematology & Oncology Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000

215 Washington St
Grafton, WI 53024
Phone (262) 375-3700

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

7878 N 76th St
Milwaukee, WI 53223
Phone (414) 354-6434

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

Interoperability endpoints

  • Direct secure messaging: cshamah620@direct.myadvocateaurora.org

Organizations & group practices 5

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 6

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1104910249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "414-352-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W GOOD HOPE RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092042",
            "telephone_number": "414-352-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMAH",
        "first_name": "COREY",
        "middle_name": "JUSTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "45708020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34771800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00474684",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cshamah620@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3003 W Good Hope Rd",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532092042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3003 W Good Hope Rd",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532092042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.