Individual provider Active NPI

Umai Shaik, M.D.

  • Pediatrics Physician
  • Pottsville, PA
National Provider Identifier
1497806269
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD058950L Issued in PA
Practice address
1851 West End Ave
Pottsville, PA 17901-3875
Phone
(570) 624-7337
Fax
(570) 624-1782
NPI assigned
Jan 16, 2007
Last updated
Oct 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD058950L PA Primary

Addresses

Primary practice location

1851 West End Ave
Pottsville, PA 17901-3875

Mailing address

48 Tunnel Rd
Suite 203
Pottsville, PA 17901-3875
Phone (570) 622-5455

Other identifiers 1

IdentifierTypeStateIssuer
01626111MedicaidPA

Other names 1

  • Dr. Umai Habiba Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110126000904 PA Practitioner - Pediatric Medicine 7012072267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

1851 W End Ave
Pottsville, PA 17901-2050
Phone (570) 624-7337

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Group P C Pediatrics CurrentSince Sep 18, 2010 Accepting new patients
Integrated Medical Group, P.C. CurrentSince Sep 18, 2010 Accepting new patients

Locations

100 Schuylkill Medical Plz
Ste 105
Pottsville, PA 17901
Phone (570) 622-4840

1851 W End Ave
Pottsville, PA 17901
Phone (570) 622-9101

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

48 Tunnel Rd
Ste 203
Pottsville, PA 17901
Phone (570) 622-5455

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

224 Claremont Ave
Tamaqua, PA 18252
Phone (570) 628-2229

Interoperability endpoints

  • Direct secure messaging: ushaik@imgpc.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1497806269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 TUNNEL RD",
            "address_2": "SUITE 203",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013875",
            "telephone_number": "570-622-5455",
            "fax_number": "570-622-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 WEST END AVE",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013875",
            "telephone_number": "570-624-7337",
            "fax_number": "570-624-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIK",
        "first_name": "UMAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD058950L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01626111",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "UMAI",
            "last_name": "HABIBA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pottsville, PA

Sources for this page

Verify at the official NPI Registry.