Individual provider Active NPI

Mai Shehata, M.D.

  • Pediatrics Physician
  • Davenport, IA
National Provider Identifier
1548588429
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
41352 Issued in IA
Practice address
3200 W Kimberly Rd
Davenport, IA 52806-3059
Phone
(563) 421-0010
Fax
(563) 421-0009
NPI assigned
May 17, 2010
Last updated
May 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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 41352 IA Primary

Addresses

Primary practice location

3200 W Kimberly Rd
Davenport, IA 52806-3059

Mailing address

3200 W Kimberly Rd
Davenport, IA 52806-3059
Phone (563) 421-0010

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mai.shehata@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20131216001233 IA Practitioner - Pediatric Medicine 9234366378 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41352IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Pediatrics CurrentSince Dec 16, 2013 Accepting new patients
Genesis Health System CurrentSince Dec 16, 2013 Accepting new patients
Genesis Health System Past Accepting new patients
Genesis Health System Past Accepting new patients
Genesis Health System PastSince Aug 4, 2025 Accepting new patients
Genesis Health System Past Accepting new patients

Locations

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287

3200 W Kimberly Rd
Davenport, IA 52806
Phone (563) 421-0010

619 5th St
Durant, IA 52747
Phone (563) 785-4487

Organizations & group practices 7

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": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1548588429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 W KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528063059",
            "telephone_number": "563-421-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 W KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528063059",
            "telephone_number": "563-421-0010",
            "fax_number": "563-421-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEHATA",
        "first_name": "MAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "41352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mai.shehata@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis health System Direct Email Adresss",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3200 W Kimberly Rd",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528063059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.