Individual provider Active NPI

Shadi Awad, M.D.

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1306296900
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301109836 Issued in MI
Practice address
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone
(313) 593-7795
NPI assigned
Jun 15, 2016
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301109836 MI Primary

Addresses

Primary practice location

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Mailing address

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CA, NY3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20191106000008 PA Practitioner - Internal Medicine 2860764321 Reassigns benefits to 1 organization
I20210222002921 CA Practitioner - HospitalistPractitioner - Internal Medicine 2860764321 Reassigns benefits to 1 organization
I20231128000621 NY Practitioner - Internal Medicine 2860764321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9333 Imperial Hwy
Downey, CA 90242-2812
Phone (800) 923-4040

9333 Rosecrans Ave
Bellflower, CA 90706-2141
Phone (562) 461-3000

9353 Imperial Hwy
Downey, CA 90242-2812
Phone (562) 657-9000

9449 Imperial Hwy
Downey, CA 90242-2814
Phone (562) 461-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.42 of 100Reported as apm
Quality
55.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301109836MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inhospital Physicians Corp Internal Medicine CurrentSince Sep 14, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 17, 2020 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 17, 2020 Accepting new patients
Cogent Medical Care PC Internal Medicine CurrentSince Oct 16, 2023 Accepting new patients
Montefiore Nyack Hospital Past Accepting new patients

Locations

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3184

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

565 Abbott Rd
Rm 8632
Buffalo, NY 14220
Phone (607) 798-5671

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

610 Sentry Pkwy
Bldg 660
Blue Bell, PA 19422

2701 DeKalb Pike
Norristown, PA 19401
Phone (215) 335-6000

Organizations & group practices 6

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 1

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": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1306296900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWAD",
        "first_name": "SHADI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301109836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.