Shaker Samih Qaqish, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

E-16018 Issued in AR

Practice address

11771 Maumelle Blvd
North Little Rock, AR 72113

Phone

(501) 204-0302

Fax

(501) 573-4111

NPI assigned

Apr 16, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, GA, OH, AR4 enrollments

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 4

Specialty

Nephrology

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.95 of 100Reported as group

Quality

86.57

Improvement activities

40

Cost

51.09

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shaker.qaqish.p155@direct.lifelinevascular.nextgenshare.com
• Direct secure messaging: shaker.qaqish.p156@direct.lifelinevascular.nextgenshare.com

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.

• Dr. Shaker LTD.

  dba Central Arkansas Access Center

  • Nephrology Physician
  • North Little Rock, AR
  • NPI 1407546518
  Medicare reassignment NPD Authorized official
• Central Arkansas Vascular & Dialysis Access Center, LLC

  • Ambulatory Surgical Clinic/Center
  • North Little Rock, AR
  • NPI 1952000309
  Medicare reassignment NPD
• Preferred Vascular Services Cleveland LLC

  dba Preferred Vascular Services Cleveland

  • Vascular Surgery Physician
  • Beachwood, OH
  • NPI 1346734365
  Medicare reassignment NPD
• Preferred Vascular Services Macon LLC

  • Vascular Surgery Physician
  • Macon, GA
  • NPI 1437659455
  Medicare reassignment NPD
• Preferred Vascular Services Northeast

  • Vascular Surgery Physician
  • Atlanta, GA
  • NPI 1780184218
  Medicare reassignment NPD
• Preferred Vascular Services Northwest, LLC

  • Vascular Surgery Physician
  • Marietta, GA
  • NPI 1598037822
  Medicare reassignment NPD
• Preferred Vascular Services Southeast LLC

  • Vascular Surgery Physician
  • Lithonia, GA
  • NPI 1861992976
  Medicare reassignment NPD
• Preferred Vascular Services Southwest

  • Vascular Surgery Physician
  • Atlanta, GA
  • NPI 1790285229
  Medicare reassignment NPD
• Gary A. Gelbfish, M.D.

  • Vascular Surgery Physician
  • Brooklyn, NY
  • NPI 1275508954
  Medicare reassignment

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

{
    "created_epoch": "1302912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1184914723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11771 MAUMELLE BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721136558",
            "telephone_number": "501-204-0302",
            "fax_number": "501-573-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11771 MAUMELLE BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "72113",
            "telephone_number": "501-204-0302",
            "fax_number": "501-573-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QAQISH",
        "first_name": "SHAKER",
        "middle_name": "SAMIH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-16",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "301234",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301114410",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A126465",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "301234",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301114410",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A126465",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "301234",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AR",
            "license": "E-16018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pulaski Technical College
• Rishik Puppala
• Christopher Joseph Purchase, PA-C
• Hoyte Remus Pyle Jr., M.D.
• Jeffrey M. Pyne, MD
• Samuel Dorian Quarles-Culliton, APRN, FNP-C
• Amelia Queen, DPT
• Brady Nicole Quick, COTA/L
• Laura Catherine Quick, MS, RD, LD
• Michael Lynn Quick, D.D.S., M.S.

• Nephrology Physician in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Nephrology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.