NPIMap

Individual provider Active NPI

Shanza Mujeeb, M.D.

  • Nephrology Physician
  • Tacoma, WA
National Provider Identifier
1174838676
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD60677530 Issued in WA
Practice address
1708 Yakima Ave Ste 107
Tacoma, WA 98405-5300
Phone
(253) 207-4850
Fax
(253) 627-7880
NPI assigned
Aug 10, 2010
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Nephrology Physician 207RN0300X MD60677530 WA Primary

Addresses

Primary practice location

1708 Yakima Ave Ste 107
Tacoma, WA 98405-5300

Mailing address

1708 Yakima Ave Ste 107
Tacoma, WA 98405-5300
Phone (253) 207-4850

Other identifiers 1

IdentifierTypeStateIssuer
2069182MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smujeeb213745@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20161219001411 WA Practitioner - NephrologyPractitioner - Internal Medicine 5597065102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1708 Yakima Ave
Suite 107
Tacoma, WA 98405-5300
Phone (253) 207-4850

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Nov 14, 2016 Accepting new patients
Franciscan Medical Group CurrentSince Nov 14, 2016 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

34509 9th Ave S
Ste 203B
Federal Way, WA 98003
Phone (253) 720-8595

1708 Yakima Ave
Ste 107
Tacoma, WA 98405
Phone (253) 207-4850

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: smujeeb213745@fhsce.catholichealth.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1174838676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE STE 107",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055300",
            "telephone_number": "253-207-4850",
            "fax_number": "253-627-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE STE 107",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055300",
            "telephone_number": "253-207-4850",
            "fax_number": "253-627-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUJEEB",
        "first_name": "SHANZA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD60677530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2069182",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smujeeb213745@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1708 Yakima Ave Ste 107",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.