Individual provider Active NPI

Sabin Gunjan Shah, M.D.

  • Orthopaedic Surgery Physician
  • Warren, MI
National Provider Identifier
1619363264
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301502067 Issued in MI
Practice address
11012 E 13 Mile Rd Ste 210
Warren, MI 48093-2547
Phone
(556) 582-0760
Fax
(586) 582-5729
NPI assigned
Apr 10, 2015
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4301502067 MI Primary

Addresses

Primary practice location

11012 E 13 Mile Rd Ste 210
Warren, MI 48093-2547

Mailing address

11012 E 13 Mile Rd Ste 112
Warren, MI 48093-2546
Phone (586) 573-8890

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
I20210914000728 MI Practitioner - Orthopedic Surgery 6800168238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Howard University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Surgery Specialists PCGroup PAC ID 7113835075, 26 clinicians

Practice addresses (Care Compare)

22401 Foster Winter Dr
FL 2
Southfield, MI 48075-3724
Phone (248) 485-8300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Clare CurrentSince Sep 1, 2021 Accepting new patients
Michigan Surgery Specialists, P.C. Orthopaedic Surgery CurrentSince May 1, 2024 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Sep 1, 2021 Accepting new patients
Michigan Surgery Specialists, P.C. CurrentSince May 1, 2024 Accepting new patients

Locations

315 E Warwick Dr
Ste B
Alma, MI 48801
Phone (989) 466-2663

602 Beech St
Ste 3100
Clare, MI 48617
Phone (989) 802-5020

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4851 E Pickard St
Mt Pleasant, MI 48858
Phone (989) 772-3009

22401 Foster Winter Dr
Fl 2
Southfield, MI 48075
Phone (248) 423-5120

11012 E 13 Mile Rd
Ste 112
Warren, MI 48093
Phone (586) 573-6880

11012 E 13 Mile Rd
Ste 201
Warren, MI 48093
Phone (586) 582-0760

11012 E 13 Mile Rd
Ste 210
Warren, MI 48093
Phone (556) 582-0760

31201 Chicago Rd S
Ste C302
Warren, MI 48093

Interoperability endpoints

  • Direct secure messaging: sshah@msspc.emadirect.md
  • Direct secure messaging: sshah117000@mymichiganhealth.midirect.net

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.

Hospital & facility affiliations 5

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": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1619363264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11012 E 13 MILE RD STE 112",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932546",
            "telephone_number": "586-573-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11012 E 13 MILE RD STE 210",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932547",
            "telephone_number": "556-582-0760",
            "fax_number": "586-582-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SABIN",
        "middle_name": "GUNJAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-10",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301502067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.