Individual provider Active NPI

Anwar Shafi, MD

  • Pediatric Pulmonology Physician
  • Springfield, IL
National Provider Identifier
1487809448
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
036-122201 Issued in IL
Practice address
301 N 8TH St
Suite Pav4A
Springfield, IL 62701-1041
Phone
(217) 545-8000
Fax
(217) 545-5018
NPI assigned
Nov 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sleep Medicine Physician 2080S0012X 036-122201 IL
Pediatric Pulmonology Physician 2080P0214X 036-122201 IL Primary

Addresses

Primary practice location

301 N 8TH St
Suite Pav4A
Springfield, IL 62701-1041

Mailing address

PO Box 19658
Springfield, IL 62794-9658
Phone (217) 545-8000

Other identifiers 1

IdentifierTypeStateIssuer
036122201MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address anwarshafi@siusm.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20101216000675 IL Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 7911195086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-122201ILMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Nov 13, 2010 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Nov 13, 2010 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Locations

2 Memorial Dr
Fl 2
Decatur, IL 62526

301 N 8th St
Ste PAV4A
Springfield, IL 62701
Phone (217) 545-4238

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003

Interoperability endpoints

  • Direct secure messaging: anwarshafi@siusm.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1487809448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19658",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949658",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 8TH ST",
            "address_2": "SUITE PAV4A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011041",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFI",
        "first_name": "ANWAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-18",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0012X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sleep Medicine",
            "state": "IL",
            "license": "036-122201",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "IL",
            "license": "036-122201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036122201",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anwarshafi@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "301 N 8th St",
            "address_2": "SUITE PAV4A",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627011041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.