Individual provider Active NPI

Sheena Paresh Shah, MD

  • Family Medicine Physician
  • Saint Clair Shores, MI
National Provider Identifier
1356978233
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301508964 Issued in MI
Practice address
25631 Little Mack Ave Ste 103
Saint Clair Shores, MI 48081-2100
Phone
(586) 443-2333
Fax
(586) 443-2332
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301508964 MI Primary

Addresses

Primary practice location

25631 Little Mack Ave Ste 103
Saint Clair Shores, MI 48081-2100

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1860

Other practice location 1

21400 E 11 Mile Rd
Saint Clair Shores, MI 48081-1566
Phone (947) 519-8100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sshah6544615@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230815003304 MI Practitioner - Family Practice 1658792684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

25631 Little Mack Ave
Suite 103
Saint Clair Shores, MI 48081-2100
Phone (586) 443-2333

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory, LLC CurrentSince Jul 24, 2023 Accepting new patients
Oakwood Ambulatory LLC Family Medicine CurrentSince Jul 24, 2023 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

25631 Little Mack Ave
Ste 103
Saint Clair Shores, MI 48081
Phone (586) 443-2333

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

21400 E 11 Mile Rd
St Clr Shores, MI 48081
Phone (586) 498-4400

Interoperability endpoints

  • Direct secure messaging: sshah1462087@epic00.shdirect.org

Organizations & group practices 3

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 4

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1356978233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25631 LITTLE MACK AVE STE 103",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812100",
            "telephone_number": "586-443-2333",
            "fax_number": "586-443-2332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21400 E 11 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "480811566",
            "country_code": "US",
            "telephone_number": "947-519-8100",
            "fax_number": "586-498-4550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHEENA",
        "middle_name": "PARESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301508964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshah6544615@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "25631 Little Mack Ave Ste 103",
            "city": "Saint Clair Shores",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480812100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.