Individual provider Active NPI

Beth-Ann Shanker, MD

  • Colon & Rectal Surgery Physician
  • Ypsilanti, MI
National Provider Identifier
1194167049
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
4301109950 Issued in MI
Practice address
5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633
Phone
(734) 712-8150
Fax
(734) 712-8151
NPI assigned
Jul 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA09095100 NJ
Colon & Rectal Surgery Physician 208C00000X ME116260 FL
Student in an Organized Health Care Education/Training Program 390200000X ME116260 FL
Colon & Rectal Surgery Physician 208C00000X 4301109950 MI Primary

Addresses

Primary practice location

5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633

Mailing address

5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633
Phone (734) 712-8150

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
I20160701001862 MI Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 9133355456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
University of Rochester School of Medicine and Dentistry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633
Phone (734) 712-8150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09095100NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Colon & Rectal Surgery CurrentSince Aug 1, 2016 Accepting new patients
Iha Health Service Corporation CurrentSince Aug 1, 2016 Accepting new patients
Iha Health Services Corporation Current Accepting new patients

Locations

49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

4990 W Clark Rd
Ste 200
Ypsilanti, MI 48197
Phone (734) 572-7500

5325 Elliott Dr
Ste 104
Ypsilanti, MI 48197
Phone (734) 434-4200

Interoperability endpoints

  • Direct secure messaging: bshanker44563@direct.trinity-health.org

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.

Hospital & facility affiliations 5

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": "1374278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1194167049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 ELLIOTT DR",
            "address_2": "SUITE 104",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978633",
            "telephone_number": "734-712-8150",
            "fax_number": "734-712-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 ELLIOTT DR",
            "address_2": "SUITE 104",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978633",
            "telephone_number": "734-712-8150",
            "fax_number": "734-712-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKER",
        "first_name": "BETH-ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA09095100",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME116260",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "ME116260",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MI",
            "license": "4301109950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.