NPIMap

Individual provider Active NPI

Stanley Shadid, MD

  • Family Medicine Physician
  • Edmond, OK
National Provider Identifier
1386904183
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29130 Issued in OK
Practice address
3030 N W 164TH St. Suite 101
Edmond, OK 73013
Phone
(405) 252-8761
Fax
(405) 272-8762
NPI assigned
May 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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 29130 OK Primary

Addresses

Primary practice location

3030 N W 164TH St. Suite 101
Edmond, OK 73013

Mailing address

5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 715-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141110000500 OK Practitioner - Family PracticePractitioner - Hospitalist 2860614765 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Physicians Group, LLCGroup PAC ID 8325950603, 107 clinicians

Practice addresses (Care Compare)

10021 S Western Ave
Oklahoma City, OK 73139-2927
Phone (405) 692-9300

1616 S Kelly Ave
Edmond, OK 73013-3651
Phone (405) 330-0032

3030 NW 164TH St
Suite 101
Edmond, OK 73013-9432
Phone (405) 341-8829

4400 Grant Blvd
Yukon, OK 73099-0037
Phone (405) 787-8550

Hospital & facility affiliations

  • Harmony Home Care II Home health agency, Piedmont, OK, CCN 377774
  • Elara Caring XX Home health agency, Oklahoma City, OK, CCN 377648
  • Carter Healthcare of Central Oklahoma, LLC Home health agency, Oklahoma City, OK, CCN 377478
  • Affinity Care of Oklahoma LLC Hospice, Oklahoma City, OK, CCN 371733
  • Community Hospital, LLC Hospital, Oklahoma City, OK, CCN 370203
  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Integris Health Edmond Hospital Hospital, Edmond, OK, CCN 370236
  • SSM Health St Anthony Hospital - Midwest Hospital, Midwest City, OK, CCN 370094

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions20
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Services of Oklahoma PC CurrentSince Jun 1, 2017 Accepting new patients
The Physicians Group LLC Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Jul 15, 2015 Accepting new patients
Community Hospital LLC Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

13190 NE 23rd St
Choctaw, OK 73020
Phone (405) 769-7201

3030 NW 164th St
Ste 101
Edmond, OK 73013
Phone (405) 252-8761

2916 N Kelly Ave
Edmond, OK 73003
Phone (405) 713-5300

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

9800 Broadway Ext
Ste 200
Oklahoma City, OK 73114
Phone (405) 715-4496

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

10021 S Western Ave
Oklahoma City, OK 73139
Phone (405) 692-9300

Interoperability endpoints

  • Direct secure messaging: sshadid14462@direct.integrisok.com

Organizations & group practices 5

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1386904183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "SUITE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-715-5300",
            "fax_number": "405-715-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 N W 164TH ST. SUITE 101",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-252-8761",
            "fax_number": "405-272-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADID",
        "first_name": "STANLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-25",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "29130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.