Shehbaz Syed Shukoor, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

33111 Issued in MS

Practice address

7620 Clarington Cove
Southaven, MS 38671

Phone

(901) 767-0101

Fax

(901) 767-0304

NPI assigned

Apr 16, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, MS2 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

Specialty

Nephrology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mittal Kidney and Dialysis, PCGroup PAC ID 9830152958, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• RCG Southaven Dialysis facility, Southaven, MS, CCN 252552
• DaVita State Line Dialysis Dialysis facility, Memphis, TN, CCN 442710
• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
• Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

Merit-based Incentive Payment System (MIPS)

Final score

98.16 of 100Reported as group

Quality

100

Promoting interoperability

99

Improvement activities

40

Cost

78.04

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GCFDAA/Endpoint/GCFDAA
• Direct secure messaging: sshukoor223329@direct.metrohealth.org
• FHIR API: https://fhir4.healow.com/fhir/r4/GCFDAA
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73850

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.

• Mittal Kidney and Dialysis PC

  • Nephrology Physician
  • Cordova, TN
  • NPI 1831201466

  MS, Nephrology, TN

  Medicare reassignment Care Compare group NPD
• Memphis Neurology PLLC

  • Neurology Physician
  • Germantown, TN
  • NPI 1700943172
  NPD
• The Metrohealth System

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1700828852
  NPD
• Kidney Care Center,P.L.L.C.

  • Nephrology Physician
  • Memphis, TN
  • NPI 1871503268

  Nephrology

  NPD (past)
• Mittal Kidney and Dialysis

  • Adult Health Clinical Nurse Specialist
  • Cordova, TN
  • NPI 1750835724
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• RCG Southaven, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Southaven, MS
  • NPI 1710099544

  Dialysis facility

  Care Compare affiliation Name & address match
• Tortugas Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
  • NPI 1336467703

  Dialysis facility

  Care Compare affiliation Name & address match
• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818

  Hospital

  Care Compare affiliation
• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172

  Hospital

  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871

  Hospital

  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890

  Hospital

  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1295398261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7260 CLARINGTON COVE",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "38671",
            "telephone_number": "901-767-0101",
            "fax_number": "901-767-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 CLARINGTON COVE",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "38671",
            "telephone_number": "901-767-0101",
            "fax_number": "901-767-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKOOR",
        "first_name": "SHEHBAZ",
        "middle_name": "SYED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-16",
        "last_updated": "2024-08-01",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "70651",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "33111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devyn Lou Shing, DMD
• Shirley a Wilson
• Amber Kaitlyn Shirley, DO
• Gwendolyn Pitcock Shirley, FNP
• Sherlean D Shugars, NP
• Kimberly Shea Shurden, PHARMD
• Brian Ivan Shwer, D.P.M.
• Sidhu Pediatrics, LLC
• Desh Deepak Sidhu, MD
• Savira Virk Sidhu, MD

• All providers in Southaven, MS
• Nephrology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.

Verify at the official NPI Registry.