Active NPI
Anwar Shafi, MD
- Pediatric Pulmonology Physician
- Springfield, IL
National Provider Identifier
1487809448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- 036-122201
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036122201 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-122201 | IL | MD | Pediatric Pulmonology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Current | 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
- 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.
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- Endocrinology, Diabetes & Metabolism Physician
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- NPI 1558385989
-
- Rural Health Clinic/Center
- Carbondale, IL
- NPI 1215978127
-
- Durable Medical Equipment & Medical Supplies
- Springfield, IL
- NPI 1164055976
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
-
- Pediatrics Physician
- Springfield, IL
- NPI 1285657379
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.