Individual provider Active NPI

Shadi Hassan Shahouri, MD

  • Rheumatology Physician
  • Wichita, KS
National Provider Identifier
1568457950
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
0429604 Issued in KS
Practice address
1921 N Webb Rd
Wichita, KS 67206-3405
Phone
(316) 612-4815
Fax
(316) 681-0244
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 0429604 KS Primary

Addresses

Primary practice location

1921 N Webb Rd
Wichita, KS 67206-3405

Mailing address

1921 N Webb Rd
Wichita, KS 67206-3405
Phone (316) 612-4815

Other identifiers 1

IdentifierTypeStateIssuer
200335690AMedicaidKS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shadi.shahouri@direct.arck.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20050719001093 KS Practitioner - RheumatologyPractitioner - Internal Medicine 3870520059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13205 W 21St CT N
Arck West
Wichita, KS 67235-9625
Phone (316) 612-4815

1921 N Webb Rd
Wichita, KS 67206-3405
Phone 31661248151280

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Quality
97.45
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0429604KSMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis and Rheumatology Clinics of Kansas LLC CurrentSince Aug 15, 2005 Accepting new patients
Arthritis and Rheumatology Clinics of Kansas LLC Rheumatology CurrentSince Aug 15, 2005 Accepting new patients

Locations

1921 N Webb Rd
Wichita, KS 67206
Phone (316) 612-4815

13205 W 21st Ct N
Wichita, KS 67235
Phone (316) 612-4815

Interoperability endpoints

  • Direct secure messaging: shadi.shahouri@direct.arck.nextgenshare.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1568457950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063405",
            "telephone_number": "316-612-4815",
            "fax_number": "316-681-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063405",
            "telephone_number": "316-612-4815",
            "fax_number": "316-681-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHOURI",
        "first_name": "SHADI",
        "middle_name": "HASSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "KS",
            "license": "0429604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200335690A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shadi.shahouri@direct.arck.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR messaging",
            "address_1": "1921 N Webb Rd",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672063405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.