Active NPI
Edward A Shadid, M.D.
- Pain Medicine Physician
- Oklahoma City, OK
National Provider Identifier
1275572398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- 24801
- Practice address
- 5900 Mosteller Drive
Suite 3
Oklahoma City, OK 73112 - Phone
- (405) 840-5100
- Fax
- (405) 840-5102
- NPI assigned
- Jun 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 22294 | OK | |
| Pain Medicine Physician | 208VP0000X | 24801 | OK | Primary |
Addresses
Primary practice location
5900 Mosteller Drive
Suite 3
Oklahoma City, OK 73112
Mailing address
5900 Mosteller Drive
Suite 3
Oklahoma City, OK 73112
Phone (405) 840-5100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200194770A | Medicaid | OK | |
| 200026630A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- University of Oklahoma College of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5109 W Gore Blvd
Lawton, OK 73505-5998
Phone (405) 840-5100
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 14.53 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 48.42
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24801 | OK | MD | Interventional Pain Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spine Care of Oklahoma, LLC | Current | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients | |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients |
Locations
508 W 15th St
Edmond, OK 73013
Phone (405) 615-0290
5109 W Gore Blvd
Lawton, OK 73505
Phone (405) 840-5100
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.
-
- Preferred Provider Organization
- Edmond, OK
- NPI 1033302906
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CCMH Ambulance Services
- Land Ambulance
- Walters, OK
- NPI 1285181610
Hospital
-
dba Comanche County Memorial Hospital
- General Acute Care Hospital
- Lawton, OK
- NPI 1720022379
-
dba CCMH Ambulance Services
- Land Ambulance
- Lawton, OK
- NPI 1770525883
Hospital
-
- Rural Acute Care Hospital
- Duncan, OK
- NPI 1851396394
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267401600000",
"number": "1275572398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 MOSTELLER DRIVE",
"address_2": "SUITE 3",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73112",
"telephone_number": "405-840-5100",
"fax_number": "405-840-5102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 MOSTELLER DRIVE",
"address_2": "SUITE 3",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73112",
"telephone_number": "405-840-5100",
"fax_number": "405-840-5102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHADID",
"first_name": "EDWARD",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2010-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OK",
"license": "22294",
"primary": false
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "OK",
"license": "24801",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200194770A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200026630A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.