Individual provider Active NPI

Maham Shahid, MD

  • Internal Medicine Physician
  • Peoria, IL
National Provider Identifier
1598438137
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036172001 Issued in IL
Practice address
8600 Il-91 Ste 130
Peoria, IL 61615
Phone
(309) 683-5050
NPI assigned
Jul 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 036.172001 IL
Adolescent Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0000X 036.172001 IL
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 036172001 IL Primary

Addresses

Primary practice location

8600 Il-91 Ste 130
Peoria, IL 61615

Mailing address

8600 Il - 91 Ste 130
Peoria, IL 61615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240930002958 IL Practitioner - Internal Medicine 8022491604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Physical Therapy Services, LTD.Group PAC ID 9133101462, shared by 5 NPIs, 216 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

61 E Side SQ
Canton, IL 61520-2603
Phone (309) 649-1572

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • St. Francis Medical Center Home health agency, Peoria, IL, CCN 147243
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Osf Saint Luke Medical Center Hospital, Kewanee, IL, CCN 141325

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.172001ILMDInternal Medicine Physician
036172001ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group Multi-Specialty CurrentSince Sep 16, 2024 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

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 4

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": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1598438137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 IL - 91 STE 130",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 IL-91 STE 130",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-683-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHID",
        "first_name": "MAHAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.172001",
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "IL",
            "license": "036.172001",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036172001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.