Individual provider Active NPI

Michael Shu

  • Obstetrics Physician
  • Wyandotte, MI
National Provider Identifier
1245692078
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
4301506438 Issued in MI
Practice address
2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone
(734) 246-6000
NPI assigned
Mar 22, 2016
Last updated
Jun 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Obstetrics & Gynecology Physician 207V00000X 304184 NY
Obstetrics Physician 207VX0000X 4301506438 MI Primary

Addresses

Primary practice location

2333 Biddle Ave
Wyandotte, MI 48192-4668

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806

Other practice location 1

219 Bryant St
University at Buffalo, Department of GYN-OB
Buffalo, NY 14222-2006
Phone (716) 878-7750

Other practice location 2

1540 Maple Rd
Williamsville, NY 14221-3647
Phone (716) 866-0681

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20200910000718 NY Practitioner - Obstetrics/Gynecology 3476890740 Reassigns benefits to 1 organization
I20220624001207 MI Practitioner - Obstetrics/Gynecology 3476890740 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
304184NYMDObstetrics & Gynecology Physician
4301506438MIMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Wyandotte Hospital CurrentSince Jun 22, 2022 Accepting new patients
Henry Ford Wyandotte Hospital Obstetrics & Gynecology CurrentSince Jun 22, 2022 Accepting new patients
Kaleida Health Current Accepting new patients
Henry Ford Wyandotte Hospital Past Accepting new patients

Locations

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

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

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

Interoperability endpoints

  • Direct secure messaging: mshu797951@direct.hfhs.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1245692078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924668",
            "telephone_number": "734-246-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 Bryant St",
            "address_2": "University at Buffalo, Department of GYN-OB",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142222006",
            "country_code": "US",
            "telephone_number": "716-878-7750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1540 Maple Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142213647",
            "country_code": "US",
            "telephone_number": "716-866-0681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHU",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "304184",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "MI",
            "license": "4301506438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.