Individual provider Active NPI

Shiraz Khaiser, MD

  • Gastroenterology Physician
  • Peoria, IL
National Provider Identifier
1568681740
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036134402 Issued in IL
Practice address
1001 Main St
Suite 500a
Peoria, IL 61606-2038
Phone
(309) 672-4980
Fax
(309) 671-2979
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 104853 FL
Gastroenterology Physician 207RG0100X 036134402 IL Primary

Addresses

Primary practice location

1001 Main St
Suite 500a
Peoria, IL 61606-2038

Mailing address

4826 N Weaverridge Blvd
Peoria, IL 61615-8946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, IL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20091104000515 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 8224176615 Reassigns benefits to 3 organizations
I20140612000946 IL Practitioner - Gastroenterology 8224176615 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Collier Hma Physician Management LLCGroup PAC ID 2769495167, 99 clinicians

Practice addresses (Care Compare)

1001 Main St
Suite 500a
Peoria, IL 61606-2038
Phone (309) 672-4980

2500 Harbor Blvd
Port Charlotte, FL 33952-5000
Phone (239) 348-4236

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
77.6
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.21 of 100Reported as group
Quality
67.65
Promoting interoperability
99
Improvement activities
40
Cost
80.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy33
Upper gastrointestinal (GI) endoscopy for acid reflux83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 104853FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Key West Hma Physician Management, LLC Internal Medicine CurrentSince Apr 8, 2024 Accepting new patients
Illinois Gastroenterology Group, LLC Gastroenterology CurrentSince Dec 1, 2020 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jan 21, 2024 Accepting new patients
Carle Health Care Incorporated Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Key West Hma Physician Management LLC CurrentSince Apr 8, 2024 Accepting new patients
Methodist Medical Center of Illinois Internal Medicine CurrentSince Jan 21, 2024 Accepting new patients
Pekin Prohealth Inc Internal Medicine CurrentSince Mar 21, 2018 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Port Charlotte Hma Physician Management LLC Internal Medicine CurrentSince Feb 9, 2025 Accepting new patients
Elgin Gastroenterology SC Gastroenterology Current Accepting new patients
Collier Hma Physician Management LLC Internal Medicine CurrentSince May 1, 2023 Accepting new patients
Collier Hma Physician Management LLC CurrentSince May 1, 2023 Accepting new patients
Port Charlotte Hma Physician Management LLC CurrentSince Feb 9, 2025 Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients

Locations

24231 Walden Center Dr
Ste 160
Estero, FL 34134
Phone (239) 348-4212

1111 12th St
Ste 104
Key West, FL 33040
Phone (305) 293-1830

8340 Collier Blvd
Ste 405
Naples, FL 34114
Phone (239) 348-4579

8300 Collier Blvd
Naples, FL 34114
Phone (239) 354-6000

6376 Pine Ridge Rd
Unit 300
Naples, FL 34119
Phone (239) 348-4128

6101 Pine Ridge Rd
Naples, FL 34119
Phone (239) 348-4000

1641 Tamiami Trl
Ste 2
Pt Charlotte, FL 33948
Phone (941) 255-3499

2500 Harbor Blvd
Pt Charlotte, FL 33952
Phone (941) 766-4122

809 E Marion Ave
Punta Gorda, FL 33950
Phone (941) 625-1951

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

101 S Major St
Eureka, IL 61530
Phone (309) 268-2172

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

600 S 13th St
#J
Pekin, IL 61554
Phone (309) 353-0607

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

815 Main St
Ste A1
Peoria, IL 61602

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

1001 Main St
Ste 500A
Peoria, IL 61606
Phone (309) 672-4980

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: shiraz.khaiser.1@4692.direct.athenahealth.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 3

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1568681740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4826 N WEAVERRIDGE BLVD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616158946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST",
            "address_2": "SUITE 500A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616062038",
            "telephone_number": "309-672-4980",
            "fax_number": "309-671-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAISER",
        "first_name": "SHIRAZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 104853",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036134402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.