NPIMap

Individual provider Active NPI

Shujauddin Syed, D.O.

  • Internal Medicine Physician
  • Pontiac, MI
National Provider Identifier
1396031324
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101019378 Issued in MI
Practice address
50 N Perry St
Pontiac, MI 48342-2217
Phone
(248) 388-5392
NPI assigned
Jun 28, 2011
Last updated
Jun 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101019378 MI Primary

Addresses

Primary practice location

50 N Perry St
Pontiac, MI 48342-2217

Mailing address

50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 388-5392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140605001972 WI Practitioner - Internal Medicine 7012150857 Reassigns benefits to 2 organizations
I20160927000261 MI Practitioner - Internal Medicine 7012150857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meriter Hospital IncGroup PAC ID 3971412735, 122 clinicians

Practice addresses (Care Compare)

202 S Park St
Madison, WI 53715-1507
Phone (608) 417-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.59 of 100Reported as group
Quality
84.57
Promoting interoperability
91
Improvement activities
40
Cost
81.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019378MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group, Michigan, PC Internal Medicine CurrentSince Sep 20, 2016 Accepting new patients
Meriter Hospital, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Meriter Hospital, Inc. Current Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Meriter Hospital, Inc. CurrentSince Mar 1, 2020 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Meriter Hospital, Inc. Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

29980 Network Pl
Chicago, IL 60673

202 S Park St
#8T
Madison, WI 53715

3102 Meriter Way
Madison, WI 53719
Phone (608) 417-8800

202 S Park St
Madison, WI 53715
Phone (608) 267-6000

202 S Park St
Ste 8T
Madison, WI 53715

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

Interoperability endpoints

  • Direct secure messaging: ssyed714722@direct.unitypoint.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1396031324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N PERRY ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422217",
            "telephone_number": "248-388-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N PERRY ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422217",
            "telephone_number": "248-388-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYED",
        "first_name": "SHUJAUDDIN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101019378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.