Individual provider Active NPI

Amjad Shihadeh, MD

  • Hospitalist Physician
  • Crown Point, IN
National Provider Identifier
1336337740
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
01067914A Issued in IN
Practice address
12750 St Francis Dr
Crown Point, IN 46307-0264
Phone
(219) 757-6121
Fax
(219) 681-6897
NPI assigned
Oct 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50911 WI
Internal Medicine Physician 207R00000X 01067914A IN
Hospitalist Physician 208M00000X 01067914A IN Primary

Addresses

Primary practice location

12750 St Francis Dr
Crown Point, IN 46307-0264

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

1201 S Main St
Crown Point, IN 46307-8481
Phone (219) 738-2100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashihadeh106173@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20100604000234 IN Practitioner - HospitalistPractitioner - Internal Medicine 6204907819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

24 Joliet St
Dyer, IN 46311-1705
Phone (219) 864-2059

Hospital & facility affiliations

  • Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50911WIMDInternal Medicine Physician
01067914AINMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network Internal Medicine CurrentSince Feb 25, 2017 Accepting new patients
Sound Physicians of Illinois, LLC Internal Medicine Past Accepting new patients
Porter Physician Services LLC Internal Medicine Past Accepting new patients
Midwest Neoped Associates LTD PastSince Jun 28, 2009 Accepting new patients

Locations

35318 Eagle Way
Chicago, IL 60678

333 Dixie Hwy
Chicago Hts, IL 60411
Phone (708) 756-0100

3700 W 203rd St
Ste 103
Olympia Flds, IL 60461
Phone (708) 679-2130

3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

12750 Saint Francis Dr
Crown Point, IN 46307
Phone (219) 738-2100

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

5454 Hohman Ave
Hammond, IN 46320
Phone (219) 933-2077

1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400

701 Superior Ave
Munster, IN 46321
Phone (219) 922-4200

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 4

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 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": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1336337740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 ST FRANCIS DR",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463070264",
            "telephone_number": "219-757-6121",
            "fax_number": "219-681-6897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 S Main St",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463078481",
            "country_code": "US",
            "telephone_number": "219-738-2100",
            "fax_number": "219-681-6867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIHADEH",
        "first_name": "AMJAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-10",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "50911",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01067914A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01067914A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashihadeh106173@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "24 Joliet St",
            "city": "Dyer",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463111705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.