Mohammad Sameer Shafi, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

036102569 Issued in IL

Practice address

812 Campus Dr
Joliet, IL 60435-5128

Phone

(815) 741-6830

Fax

(815) 741-6832

NPI assigned

Sep 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, WI, TN3 enrollments

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 3

Specialty

NephrologyAlso: Critical Care (Intensivists), Internal Medicine

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Germane Nephrology AssociatesGroup PAC ID 0446223838, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• FMC - Joliet Dialysis facility, Joliet, IL, CCN 142739
• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Germane Nephrology Associates

  • Nephrology Physician
  • Joliet, IL
  • NPI 1194755272
  Medicare reassignment Care Compare group NPD
• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  Medicare reassignment NPD
• Tennessee Kidney Care PLLC

  • Nephrology Physician
  • Cleveland, TN
  • NPI 1073963716
  Medicare reassignment NPD
• Germane Nephrology Associates

  • Specialist
  • Morris, IL
  • NPI 1215268081
  NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD
• Dialysis Care Center McHenry LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • McHenry, IL
  • NPI 1457854655
  NPD (past)
• Fresenius Medical Care of Plainfield, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Joliet, IL
  • NPI 1124388624
  NPD (past)
• Home Dialysis Services Elk Grove LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Schaumburg, IL
  • NPI 1194198150
  NPD (past)
• Home Dialysis Services LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Homer Glen, IL
  • NPI 1891066833
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fresenius Medical Care of Plainfield, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Joliet, IL
  • NPI 1124388624

  Dialysis facility

  Care Compare affiliation Name & address match
• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1528052792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3877",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604343877",
            "telephone_number": "815-741-6830",
            "fax_number": "815-741-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 CAMPUS DR",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355128",
            "telephone_number": "815-741-6830",
            "fax_number": "815-741-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFI",
        "first_name": "MOHAMMAD",
        "middle_name": "SAMEER",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036102569",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036102569",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036102569",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036102569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102569",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Joliet, IL
• Providers in Joliet, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.

Verify at the official NPI Registry.