NPIMap

Individual provider Active NPI

Mohamed Shafiu, MD

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1174685648
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
N2789 Issued in TX
Practice address
5620 Lone Star Pkwy # 2
San Antonio, TX 78253-2202
Phone
(210) 403-7978
Fax
(210) 680-0206
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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 TRN7390 FL
Nephrology Physician 207RN0300X N2789 TX Primary

Addresses

Primary practice location

5620 Lone Star Pkwy # 2
San Antonio, TX 78253-2202

Mailing address

16620 N US Highway 281 Ste 300
San Antonio, TX 78232-2679
Phone (210) 614-1231

Other practice location 1

2201 N Bedell Ave Ste E
Del Rio, TX 78840-8021
Phone (830) 774-4723

Other identifiers 1

IdentifierTypeStateIssuer
206371101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090819000629 TX Practitioner - Nephrology 7315091782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renal Associates, P.a.Group PAC ID 8729070628, 40 clinicians

Practice addresses (Care Compare)

5620 Lone Star Pkwy
Suite 2
San Antonio, TX 78253-2202
Phone (210) 403-7978

Hospital & facility affiliations

  • FKC Alamo Ranch Dialysis facility, San Antonio, TX, CCN 672875
  • Fresenius Medical Care Westover Hills Dialysis facility, San Antonio, TX, CCN 452507
  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388
  • Methodist Hospital Stone Oak Hospital, San Antonio, TX, CCN 670055
  • Christus Santa Rosa Medical Center Hospital, San Antonio, TX, CCN 450237
  • Westover Hills Baptist Hospital Hospital, San Antonio, TX, CCN 670333
  • Val Verde Regional Medical Center Hospital, Del Rio, TX, CCN 450154

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN7390FLMDInternal Medicine Physician
N2789TXMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: mohamed.shafiu@ra.eclinicaldirectplus.com

Organizations & group practices 1

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 9

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1174685648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16620 N US HIGHWAY 281 STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322679",
            "telephone_number": "210-614-1231",
            "fax_number": "210-616-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 LONE STAR PKWY # 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782532202",
            "telephone_number": "210-403-7978",
            "fax_number": "210-680-0206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 N Bedell Ave Ste E",
            "address_purpose": "LOCATION",
            "city": "Del Rio",
            "state": "TX",
            "postal_code": "788408021",
            "country_code": "US",
            "telephone_number": "830-774-4723",
            "fax_number": "830-774-4726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFIU",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN7390",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "N2789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206371101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.