Individual provider Active NPI

Imam H Shaik, M.D

  • Hospitalist Physician
  • Tyler, TX
National Provider Identifier
1609294586
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
R2222 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 606-4129
NPI assigned
Mar 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X R2222 TX Primary
Internal Medicine Physician 207R00000X 26546 WV

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6400

Other practice location 1

2900 1st Ave
Huntington, WV 25702-1241
Phone (304) 399-7692

Other identifiers 2

IdentifierTypeStateIssuer
1F0470OtherTXMEDICARE
376411002MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170719002404 TX Practitioner - HospitalistPractitioner - Internal Medicine 0648587808 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Texas Physician Services, PLLCGroup PAC ID 6305295429, 236 clinicians

Practice addresses (Care Compare)

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 593-8441

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
  • Christus Mother Frances Hospital- Jacksonville Hospital, Jacksonville, TX, CCN 451319
  • Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236
  • Christus Mother Frances Hospital- Jacksonville Nursing home, CCN 45Z319

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Texas Physician Services, PLLC Internal Medicine CurrentSince Apr 1, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 17, 2020 Accepting new patients
Sound Inpatient Physicians of Texas I, Inc Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Sep 17, 2020 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jun 10, 2017 Accepting new patients
Sound Inpatient Physicians of Texas I, Inc Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Sound Inpatient Physicians of Texas I, Inc Internal Medicine Current Accepting new patients
Mother Frances Hospital Regional Health Care Center Past Accepting new patients

Locations

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Fl 4
Tyler, TX 75701
Phone (903) 531-4080

Interoperability endpoints

  • Direct secure messaging: ishaik144587@christushealth.direct-ci.net

Organizations & group practices 8

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": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1609294586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-606-4129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257021241",
            "country_code": "US",
            "telephone_number": "304-399-7692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAIK",
        "first_name": "IMAM",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-28",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "R2222",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "26546",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1F0470",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376411002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.