Individual provider Active NPI

Sami Shayya

  • Emergency Medicine Physician
  • Detroit, MI
National Provider Identifier
1619455391
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101271428 Issued in VA
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-3284
NPI assigned
Aug 3, 2018
Last updated
Jul 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101271428 VA Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

2799 W. Grand Boulevard
Medical Education Department
Detroit, MI 48202
Phone (313) 916-3284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MA2 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
I20210709001631 VA Practitioner - Emergency Medicine 3274935432 Reassigns benefits to 1 organization
I20250221002440 MA Practitioner - Emergency Medicine 3274935432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tufts Medical Center Ep LLCGroup PAC ID 0446306716, 12 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-4721

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.52 of 100Reported as group
Quality
91.6
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101271428VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tufts Medical Center Ep LLC Emergency Medicine CurrentSince Dec 20, 2024 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

12420 Milestone Center Dr
Ste 200
Germantown, MD 20876
Phone (336) 509-7515

60 E Roslyn Ct
Colonial Hgts, VA 23834
Phone (804) 765-5000

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

Interoperability endpoints

  • Direct secure messaging: sshayya127274@tuftsmedicine.direct-ci.com
  • Direct secure messaging: sshayya442235@direct.hfhs.org

Organizations & group practices 3

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 1

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": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1619455391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W. GRAND BOULEVARD",
            "address_2": "MEDICAL EDUCATION DEPARTMENT",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-3284"
        },
        {
            "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": "313-916-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAYYA",
        "first_name": "SAMI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-03",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101271428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.