NPIMap

Individual provider Active NPI

Shubi Shahida, MD

  • Internal Medicine Physician
  • Smithfield, NC
National Provider Identifier
1407803562
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2005-01514 Issued in NC
Practice address
712 Wilkins St
Smithfield, NC 27577-4664
Phone
(919) 989-9109
Fax
(919) 989-9821
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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 2005-01514 NC Primary

Addresses

Primary practice location

712 Wilkins St
Smithfield, NC 27577-4664

Mailing address

712 Wilkins St Ste a
Smithfield, NC 27577-4664
Phone (919) 989-9109

Other identifiers 2

IdentifierTypeStateIssuer
5902696MedicaidNC
P00356481OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20060128000015 NC Practitioner - Internal Medicine 5799799755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

712 Wilkins St
Suite a
Smithfield, NC 27577-4664
Phone (919) 989-9109

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.65 of 100Reported as individual
Quality
80.6
Improvement activities
40
Cost
74.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2005-01514NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shubi Shahida, MD, PC Internal Medicine CurrentSince Apr 26, 2006 Accepting new patients
Dr. Shubi Shahida Current Accepting new patients

Locations

425 Huehl Rd
Bldg 8
Northbrook, IL 60062
Phone (847) 754-4780

712 Wilkins St
Ste A
Smithfield, NC 27577
Phone (919) 934-5441

Organizations & group practices 2

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 7

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1407803562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 WILKINS ST STE A",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774664",
            "telephone_number": "919-989-9109",
            "fax_number": "919-989-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 WILKINS ST",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774664",
            "telephone_number": "919-989-9109",
            "fax_number": "919-989-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHIDA",
        "first_name": "SHUBI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2005-01514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902696",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00356481",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

Verify at the official NPI Registry.