Individual provider Active NPI

Shalamar D Sibley, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Minneapolis, MN
National Provider Identifier
1154403103
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
43242 Issued in MN
Practice address
516 Delaware St SE
PWB Sixth Floor, Clinic 6a
Minneapolis, MN 55455-0356
Phone
(612) 625-8690
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43242 MN
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 43242 MN Primary

Addresses

Primary practice location

516 Delaware St SE
PWB Sixth Floor, Clinic 6a
Minneapolis, MN 55455-0356

Mailing address

420 Delaware St SE
MMC 101
Minneapolis, MN 55455-0341
Phone (612) 624-5150

Other identifiers 1

IdentifierTypeStateIssuer
93R17SIOtherMNBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20100714001023 MN Practitioner - EndocrinologyPractitioner - Internal Medicine 0042342891 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Tennessee, HSC, College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43242MNMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Mar 24, 2010 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Health Services Internal Medicine CurrentSince Mar 24, 2010 Accepting new patients
Fairview Express Care Current Accepting new patients

Locations

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

420 Delaware St SE
#101
Minneapolis, MN 55455
Phone (612) 624-5150

516 Delaware St SE
Fl Sixth
Minneapolis, MN 55455
Phone (612) 625-4680

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • Direct secure messaging: ssibley7908@fairview.direct-ci.com

Organizations & group practices 8

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1154403103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 101",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-624-5150",
            "fax_number": "612-626-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 DELAWARE ST SE",
            "address_2": "PWB SIXTH FLOOR, CLINIC 6A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550356",
            "telephone_number": "612-625-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBLEY",
        "first_name": "SHALAMAR",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "43242",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MN",
            "license": "43242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "93R17SI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.