NPIMap

Individual provider Active NPI

Qaiser Shafiq, M.D.

  • Interventional Cardiology Physician
  • Southgate, MI
National Provider Identifier
1225294168
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
4301116187 Issued in MI
Practice address
15150 Fort St
Southgate, MI 48195
Phone
(734) 282-4800
Fax
(734) 282-9302
NPI assigned
Jul 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 243643 MA
Internal Medicine Physician 207R00000X 35.092375 OH
Cardiovascular Disease Physician 207RC0000X 35.092375 OH
Interventional Cardiology Physician 207RI0011X 4301116187 MI Primary

Addresses

Primary practice location

15150 Fort St
Southgate, MI 48195

Mailing address

15150 Fort St
Southgate, MI 48195-1302
Phone (734) 282-4800

Other identifiers 1

IdentifierTypeStateIssuer
0174144MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TX, WI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180924002148 MI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 8527206937 Reassigns benefits to 5 organizations
I20240603004149 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Interventional Cardiology 8527206937 Reassigns benefits to 1 organization
I20260410000869 WI Practitioner - Interventional Cardiology 8527206937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Downriver Heart and Vascular Specialists, PCGroup PAC ID 2062416522, 8 clinicians
Henry Ford Wyandotte HospitalGroup PAC ID 2264334499, shared by 9 NPIs, 194 clinicians
Ccmma TX PLLCGroup PAC ID 6305275611, 15 clinicians

Practice addresses (Care Compare)

15150 Fort St
Southgate, MI 48195-1302
Phone (734) 282-4800

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-6000

2561 Knollwood Dr
Canton, MI 48188-2271
Phone (240) 441-2525

8454 Grays Dr
Grosse Ile, MI 48138-1593
Phone (845) 702-2711

Hospital & facility affiliations

  • Axiom Home Care Home health agency, Southgate, MI, CCN 239018
  • Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146
  • Corewell Health Trenton Hospital Hospital, Trenton, MI, CCN 230176
  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Beaumont Hospital - Taylor Hospital, Taylor, MI, CCN 230270
  • Saint Rose Dominican Hospitals - North Las Vegas Hospital, North Las Vegas, NV, CCN 290058

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting57
Pacemaker insertion or repair42
Varicose vein removal11
Leg revascularization (restoring blood flow)20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.092375OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clearview Diagnostics LLC CurrentSince Mar 2, 2025 Accepting new patients
Downriver Heart and Vascular Specialists PC Cardiovascular Disease CurrentSince Aug 12, 2018 Accepting new patients
Henry Ford Wyandotte Hospital Current Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince May 22, 2019 Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince May 22, 2019 Accepting new patients
Henry Ford Wyandotte Hospital Cardiovascular Disease CurrentSince Jan 1, 2024 Accepting new patients
Henry Ford Macomb Hospital Corporation Past Accepting new patients
Ccmma NJ LLC PastSince Oct 28, 2025 Accepting new patients
Ccmma Ca PC Past Accepting new patients

Locations

23050 West Rd
Ste 120
Brownstown Twp, MI 48183
Phone (734) 671-1510

1 Ford Pl
#3A
Detroit, MI 48202
Phone (248) 703-1795

15150 Fort St
Southgate, MI 48195
Phone (734) 282-4800

15150 Fort St
Spc Pc
Southgate, MI 48195
Phone (734) 282-4800

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

Interoperability endpoints

  • Direct secure messaging: qshafiq529747@direct.hfhs.org

Organizations & group practices 11

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 12

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": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1225294168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15150 FORT ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951302",
            "telephone_number": "734-282-4800",
            "fax_number": "734-282-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15150 FORT ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "48195",
            "telephone_number": "734-282-4800",
            "fax_number": "734-282-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFIQ",
        "first_name": "QAISER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "243643",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.092375",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.092375",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MI",
            "license": "4301116187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0174144",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.