NPIMap

Individual provider Active NPI

Shayan Ul Haque, MD

  • Neurocritical Care Physician
  • Phoenix, AZ
National Provider Identifier
1275057598
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
67791 Issued in AZ
Practice address
250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone
(480) 331-6721
Fax
(602) 296-7738
NPI assigned
Jul 28, 2017
Reactivated
Aug 9, 2023
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 67791 AZ
Neurological Surgery Physician 207T00000X 67791 AZ
Neurology Physician 2084N0400X 67791 AZ
Vascular Neurology Physician 2084V0102X 67791 AZ
Neurocritical Care Physician 2084A2900X 67791 AZ Primary

Addresses

Primary practice location

250 E Dunlap Ave
Phoenix, AZ 85020-2825

Mailing address

111 E Dunlap Ave Ste I-279
Phoenix, AZ 85020-2807
Phone (480) 331-6721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230525000523 AZ Practitioner - NeuropsychiatryPractitioner - Critical Care (Intensivists) 4981060407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeuropsychiatryAlso: Critical Care (Intensivists)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurocritical Care and Stroke of Arizona PLLCGroup PAC ID 0143493882, 5 clinicians

Practice addresses (Care Compare)

250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (480) 331-6721

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67791AZMDNeurology Physician

Organizations & group practices 1

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.

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": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1275057598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E DUNLAP AVE STE I-279",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202807",
            "telephone_number": "480-331-6721",
            "fax_number": "602-296-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E DUNLAP AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202825",
            "telephone_number": "480-331-6721",
            "fax_number": "602-296-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "SHAYAN UL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-28",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "deactivation_date": "2023-07-28",
        "reactivation_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AZ",
            "license": "67791",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AZ",
            "license": "67791",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "67791",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "AZ",
            "license": "67791",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "AZ",
            "license": "67791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.