Active NPI
Thomas M Shehab, M.D.
- Gastroenterology Physician
- Ypsilanti, MI
National Provider Identifier
1114906559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 065691
- Practice address
- 5300 Elliott Dr
Ypsilanti, MI 48197-8632 - Phone
- (734) 434-6262
- Fax
- (734) 712-2820
- NPI assigned
- Jan 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 065691 | MI | Primary |
Addresses
Primary practice location
5300 Elliott Dr
Ypsilanti, MI 48197-8632
Mailing address
5300 Elliott Dr
Ypsilanti, MI 48197-8632
Phone (734) 434-6262
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023609 | Other | MI | MIDWEST HEALTH PLAN |
| 3949257 | Other | MI | CIGNA |
| 4399723 | Medicaid | MI | |
| 28223 | Other | MI | AETNA |
| 0812248 | Other | MI | BCBS INDIVIDUAL |
| 110239995 | Other | MI | MEDICARE RAILROAD PTAN |
| 0H14989 | Other | MI | BCBS GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 065691 | MI | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263427200000",
"number": "1114906559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 ELLIOTT DR",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481978632",
"telephone_number": "734-434-6262",
"fax_number": "734-712-2820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 ELLIOTT DR",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481978632",
"telephone_number": "734-434-6262",
"fax_number": "734-712-2820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEHAB",
"first_name": "THOMAS",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2010-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MI",
"license": "065691",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDWEST HEALTH PLAN",
"identifier": "023609",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3949257",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4399723",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "28223",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS INDIVIDUAL",
"identifier": "0812248",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD PTAN",
"identifier": "110239995",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP",
"identifier": "0H14989",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.