NPIMap

Individual provider Active NPI

Shabnam Moshref, D.O.

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1275844102
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
02004349A Issued in IN
Practice address
8920 Southpointe Dr
Suite B
Indianapolis, IN 46227-7509
Phone
(317) 497-1900
Fax
(317) 497-1919
NPI assigned
Jun 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 02004349A IN Primary
General Practice Physician 208D00000X 5101018943 MI

Addresses

Primary practice location

8920 Southpointe Dr
Suite B
Indianapolis, IN 46227-7509

Mailing address

6626 E. 75TH Street
Suite 500
Indianapolis, IN 46250-2890
Phone (317) 497-6333

Other identifiers 2

IdentifierTypeStateIssuer
2010202340MedicaidIN
P01347725OtherINMEDICARE RR PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smoshref115627@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20140226000492 IN Practitioner - Internal Medicine 4284864935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

13050 Parkside Dr
Suite 101
Fishers, IN 46038-8247
Phone (317) 621-2890

7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444

8920 Southpointe Dr
Indianapolis, IN 46227-7505

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02004349AINMDInternal Medicine Physician
5101018943MIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Jan 27, 2014 Accepting new patients
Community Physicians of Indiana Inc Internal Medicine CurrentSince Jan 27, 2014 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

8920 Southpointe Dr
Ste B
Indianapolis, IN 46227
Phone (317) 497-1900

Interoperability endpoints

  • Direct secure messaging: smoshref115627@ecommunitydirect.com

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.

Hospital & facility affiliations 10

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1275844102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E. 75TH STREET",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-497-6333",
            "fax_number": "317-497-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 SOUTHPOINTE DR",
            "address_2": "SUITE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462277509",
            "telephone_number": "317-497-1900",
            "fax_number": "317-497-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHREF",
        "first_name": "SHABNAM",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02004349A",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101018943",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010202340",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PTAN",
            "identifier": "P01347725",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smoshref115627@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "8920 Southpointe Dr",
            "address_2": "Suite B",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462277509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.