Khader Samer-Fayez Shamieh, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

202211 Issued in LA

Practice address

76 Starbrush Cir
Covington, LA 70433-7208

Phone

(844) 800-3472

NPI assigned

May 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Orthopedic Surgery

Education

Louisiana State University School of Medicine in Shreveport, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Diagnostic and Interventional Spinal Care of LouisianaGroup PAC ID 0244460293, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avala Hospital, Covington, LA, CCN 190267

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3401/brand/1/csg/1/fhir/r4
• Direct secure messaging: shamieh@disc-of-louisiana.direct.kno2fy.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Fairway Medical Center, LLC

  • General Acute Care Hospital
  • Covington, LA
  • NPI 1851487086

  5% Or Greater Indirect Ownership Interest, Operational/Managerial Control

  CMS ownership

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.

• Diagnostic and Interventional Spinal Care of Louisiana

  • Orthopaedic Surgery of the Spine Physician
  • Covington, LA
  • NPI 1659616696
  Medicare reassignment Care Compare group NPD
• Avala Physician Network, LLC

  • Multi-Specialty Clinic/Center
  • Covington, LA
  • NPI 1922694710

  Orthopaedic Surgery

  Medicare reassignment NPD
• Northlake Neurological Institute LLC

  • Neurology Physician
  • Lacombe, LA
  • NPI 1689997561
  NPD (past)
• Paradigm Health System

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Lacombe, LA
  • NPI 1043634454
  NPD (past)

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

• Fairway Medical Center, LLC

  • General Acute Care Hospital
  • Covington, LA
  • NPI 1851487086
  Care Compare affiliation

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1225249170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 STARBRUSH CIR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337208",
            "telephone_number": "844-800-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 STARBRUSH CIR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337208",
            "telephone_number": "844-800-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMIEH",
        "first_name": "KHADER",
        "middle_name": "SAMER-FAYEZ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "44456",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "202211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07910",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa J Sendra, CRNA
• Maria M Senette, P.T.
• Nicole Sesser, NP-C
• Blane Adam Sessions, M.D.
• John Lewis Sfondouris, M.D.
• Sara Garcia Shank, MD, FAAP
• Stacy Sharp, FNP
• Brooke Elaine Sharpe
• Julie Dean Shartle, LCSW
• Christen Severson Shea, FNP

• Orthopaedic Surgery Physician in Covington, LA
• Providers in Covington, LA by specialty
• Orthopaedic Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.