Individual provider Active NPI

Brian Scott Shapiro, M.D.

  • Surgery Physician
  • Grand Blanc, MI
National Provider Identifier
1114989688
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
BS053139 Issued in MI
Practice address
9463 Holly Rd
Suite 102
Grand Blanc, MI 48439-8351
Phone
(810) 579-2600
Fax
(810) 579-2601
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X BS053139 MI Primary

Addresses

Primary practice location

9463 Holly Rd
Suite 102
Grand Blanc, MI 48439-8351

Mailing address

9463 Holly Rd
Suite 102
Grand Blanc, MI 48439-8351
Phone (810) 579-2600

Other identifiers 1

IdentifierTypeStateIssuer
2951302MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20101013001062 MI Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 6608895917 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BS053139MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc. Current Accepting new patients
Covenant Medical Center, Inc CurrentSince Aug 30, 2023 Accepting new patients
Nephrology & Internal Medicine PC CurrentSince Apr 1, 2025 Accepting new patients

Locations

9463 Holly Rd
Ste 102
Grand Blanc, MI 48439
Phone (810) 579-2600

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1114989688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9463 HOLLY RD",
            "address_2": "SUITE 102",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398351",
            "telephone_number": "810-579-2600",
            "fax_number": "810-579-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9463 HOLLY RD",
            "address_2": "SUITE 102",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398351",
            "telephone_number": "810-579-2600",
            "fax_number": "810-579-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "BRIAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "BS053139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2951302",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.