Individual provider Active NPI

Ruqiya Shama Tareen, M.D.

  • Psychiatry Physician
  • Kalamazoo, MI
National Provider Identifier
1598724122
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301078095 Issued in MI
Practice address
1717 Shaffer St
Suite 010
Kalamazoo, MI 49048-1647
Phone
(269) 337-6373
Fax
(269) 337-6376
NPI assigned
Mar 22, 2006
Last updated
Jun 14, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301078095 MI Primary

Addresses

Primary practice location

1717 Shaffer St
Suite 010
Kalamazoo, MI 49048-1647

Mailing address

1000 Oakland Dr
Kalamazoo, MI 49008-1282

Other identifiers 2

IdentifierTypeStateIssuer
4746089MedicaidMI
2603911632OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050720000240 MI Practitioner - Psychiatry 5092742239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5930 Lovers LN
Suite 3
Portage, MI 49002-1673
Phone (269) 381-6950

Merit-based Incentive Payment System (MIPS)

Final score
97.1 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301078095MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Michigan Psychiatric Services LLC Psychiatry CurrentSince Oct 1, 2010 Accepting new patients
Western Michigan University School of Medicine CurrentSince Jul 1, 2012 Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies CurrentSince Jul 1, 2012 Accepting new patients
South Michigan Psychiatric Services LLC CurrentSince Oct 1, 2010 Accepting new patients

Locations

1000 Oakland Dr
Kalamazoo, MI 49008
Phone (269) 337-4347

1717 Shaffer St
Ste 10
Kalamazoo, MI 49048
Phone (269) 337-6200

900 Peeler St
Kalamazoo, MI 49008
Phone (269) 345-8618

5930 Lovers Ln
Ste 3
Portage, MI 49002
Phone (269) 381-6950

Interoperability endpoints

  • Direct secure messaging: kalamazootms.tareen.ruqiya@140035.advancedmd-direct.com

Organizations & group practices 4

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1598724122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 OAKLAND DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SHAFFER ST",
            "address_2": "SUITE 010",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481647",
            "telephone_number": "269-337-6373",
            "fax_number": "269-337-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAREEN",
        "first_name": "RUQIYA",
        "middle_name": "SHAMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301078095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4746089",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2603911632",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.