Individual provider Active NPI

Shad Jawaid, MD

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1114927415
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q0942 Issued in TX
Practice address
2301 River Rd
Suite 302
Louisville, KY 40206-1010
Phone
(502) 814-3175
Fax
(502) 426-5493
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 31235 KY
Internal Medicine Physician 207R00000X Q0942 TX Primary

Addresses

Primary practice location

2301 River Rd
Suite 302
Louisville, KY 40206-1010

Mailing address

2301 River Rd
Suite 302
Louisville, KY 40206-1010
Phone (502) 814-3175

Other identifiers 3

IdentifierTypeStateIssuer
359814MedicaidAZ
64312358MedicaidKY
200518860MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjawaid918439@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220317000474 TX Practitioner - Internal Medicine 8921091471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

12505 Lebanon Rd
Suite 1442
Frisco, TX 75035-8298
Phone (972) 963-3550

4001 Worth St
Dallas, TX 75246-1608

4700 Alliance Blvd
Plano, TX 75093-5323

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

  • Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890
  • Baylor Scott and White Medical Center Frisco at PG Hospital, Frisco, TX, CCN 670346
  • Baylor Scott & White Medical Center - Centennial Hospital, Frisco, TX, CCN 450885
  • Baylor Scott & White the Heart Hospital Plano Hospital, Plano, TX, CCN 670025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q0942TXMDInternal Medicine Physician
31235KYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Feb 1, 2022 Accepting new patients
Healthtexas Provider Network CurrentSince Feb 1, 2022 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Baylor Regional Medical Center at Plano Past Accepting new patients
Norton Enterprises, Inc. Past Accepting new patients
Hospital Medicine Associates, P.C. Internal Medicine Past Accepting new patients
Community Medical Associates, Inc. Internal Medicine Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

7600 Better Way
Frisco, TX 75033
Phone (214) 407-5322

4700 Alliance Blvd
Ste 400
Plano, TX 75093
Phone (469) 814-6631

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Organizations & group practices 7

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 4

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1114927415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 RIVER RD",
            "address_2": "SUITE 302",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061010",
            "telephone_number": "502-814-3175",
            "fax_number": "502-426-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 RIVER RD",
            "address_2": "SUITE 302",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061010",
            "telephone_number": "502-814-3175",
            "fax_number": "502-426-5493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAWAID",
        "first_name": "SHAD",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "31235",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q0942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "359814",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64312358",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200518860",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjawaid918439@direct.sw.org",
            "affiliation": "N",
            "address_1": "4700 Alliance Blvd Ste 400",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750935323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.