Individual provider Active NPI

Ali Shafiq, M.D.

  • Cardiovascular Disease Physician
  • Detroit, MI
National Provider Identifier
1609005503
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
65349 Issued in WI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 743-4012
NPI assigned
Jul 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301094094 MI
Internal Medicine Physician 207R00000X 65349 WI
Cardiovascular Disease Physician 207RC0000X 65349 WI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, 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
I20161219000968 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - HospitalistPractitioner - Internal Medicine 5294985792 Reassigns benefits to 2 organizations
I20230527000317 IL Practitioner - Interventional Cardiology 5294985792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

1340 Charles St
Suite 300
Rockford, IL 61104-2200
Phone (779) 696-8800

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228
  • FHN Memorial Hospital Hospital, Freeport, IL, CCN 140160
  • Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting30

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine CurrentSince Feb 28, 2018 Accepting new patients
Mercy Health System Corporation CurrentSince Dec 18, 2017 Accepting new patients
Mercy Health System Corporation CurrentSince Dec 18, 2017 Accepting new patients
Swedishamerican Hospital Internal Medicine Current Accepting new patients
Swedishamerican Hospital CurrentSince Mar 13, 2023 Accepting new patients
Swedishamerican Hospital CurrentSince Mar 13, 2023 Accepting new patients
Prohealth Medical Group Inc Internal Medicine Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1340 Charles St
Ste 300
Rockford, IL 61104
Phone (779) 696-5888

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Interoperability endpoints

  • Direct secure messaging: ashafiq144843@direct.phci.org

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 and National Provider Directory roles.

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": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1609005503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031",
            "telephone_number": "262-928-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-743-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFIQ",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-13",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301094094",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "65349",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "65349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.