Individual provider Active NPI

Mariam Shetab, MD

  • Family Medicine Physician
  • Redding, CA
National Provider Identifier
1346731650
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A173992 Issued in CA
Practice address
2175 Rosaline Ave
Redding, CA 96001-2549
Phone
(530) 225-6000
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A173992 CA
Hospitalist Physician 208M00000X 036176497 IL
Family Medicine Physician 207Q00000X A173992 CA Primary

Addresses

Primary practice location

2175 Rosaline Ave
Redding, CA 96001-2549

Mailing address

2100 Powell St Ste 400
Emeryville, CA 94608-1826
Phone (510) 350-2600

Other practice location 1

425 Wind Ridge Dr
Wausau, WI 54401-4149
Phone (715) 675-3391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL, 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
I20210805000939 CA Practitioner - HospitalistPractitioner - Family Practice 6709280290 Reassigns benefits to 2 organizations
I20250929000023 IL Practitioner - Hospitalist 6709280290 Reassigns benefits to 1 organization
I20251105002903 NY Practitioner - Hospitalist 6709280290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 334-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.8 of 100Reported as individual
Quality
80.29
Improvement activities
0
Cost
75.48

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A173992CAMDHospitalist Physician
036176497ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Medical Physician Associates PC Hospitalist CurrentSince Nov 1, 2025 Accepting new patients
New York Medical Physician Associates PC Hospitalist CurrentSince Nov 1, 2025 Accepting new patients
Galen Inpatient Physicians Inc CurrentSince Aug 1, 2024 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Aug 1, 2024 Accepting new patients
Vituity Hospitalists PC Hospitalist CurrentSince Aug 1, 2021 Accepting new patients
Cep America-Illinois Hospitalists Hospitalist CurrentSince Aug 15, 2025 Accepting new patients
Vituity Hospitalists PC Hospitalist CurrentSince Aug 1, 2021 Accepting new patients
Cep America-Illinois Hospitalists, LLP Current Accepting new patients
Galen Inpatient Physicians, PC Hospitalist Current Accepting new patients
Cep America - Illinois Hospitalists, LLP CurrentSince Aug 15, 2025 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2175 Rosaline Ave
Redding, CA 96001
Phone (530) 225-7247

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534

Organizations & group practices 10

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 2

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": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1346731650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 400",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 ROSALINE AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012549",
            "telephone_number": "530-225-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 Wind Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Wausau",
            "state": "WI",
            "postal_code": "544014149",
            "country_code": "US",
            "telephone_number": "715-675-3391",
            "fax_number": "715-675-5262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHETAB",
        "first_name": "MARIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A173992",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036176497",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A173992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.