Shabana Feroz, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

106469 Issued in MN

Practice address

7840 Vinewood LN N
Maple Grove, MN 55369-7185

Phone

(763) 236-0200

Fax

(763) 420-5531

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Thunder Bay Community Health Service, Inc

  • Federally Qualified Health Center (FQHC)
  • Atlanta, MI
  • NPI 1639123623
  NPD (past)
• Thunder Bay Community Health Service, Inc

  • Federally Qualified Health Center (FQHC)
  • Hillman, MI
  • NPI 1942253851
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1326091331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "989-742-4583",
            "fax_number": "989-742-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 VINEWOOD LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697185",
            "telephone_number": "763-236-0200",
            "fax_number": "763-420-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEROZ",
        "first_name": "SHABANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "106469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4162464",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4884782",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4162375",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE BILL PAY TO",
            "identifier": "0F06016",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4162455",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pennelope H Fearing, ANP
• Jennifer Erin Feather, D.C.
• Matthias M Feldkamp, M.D., PH.D.
• Isaac Felemovicius, M.D.
• Sarah Femrite
• Thomas Bruce Ferrara, M.D.
• Joanne M Finnegan, MA, LMFT
• Kristen Marie Finnegan, PA-C
• Ifrah Fiqi
• First Choice Residential LLC

• Family Medicine Physician in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.