Individual provider Active NPI

Shamas Moheyuddin, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Ann Arbor, MI
National Provider Identifier
1619942596
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
4301085148 Issued in MI
Practice address
3120 Professional Dr
Ann Arbor, MI 48104-5131
Phone
(734) 677-6000
Fax
(734) 677-2422
NPI assigned
Feb 22, 2006
Last updated
Jul 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 4301085148 MI Primary
Interventional Pain Medicine Physician 208VP0014X 4301085148 MI

Addresses

Primary practice location

3120 Professional Dr
Ann Arbor, MI 48104-5131

Mailing address

3120 Professional Dr
Ann Arbor, MI 48104-5131
Phone (734) 677-6000

Other identifiers 1

IdentifierTypeStateIssuer
4758007MedicaidMI

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
I20050707000646 MI Practitioner - AnesthesiologyPractitioner - Pain ManagementPractitioner - NeurologyPractitioner - Interventional Pain Management 7517903990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management, Pain Management
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3120 Professional Dr
Ann Arbor, MI 48104-5131
Phone (734) 677-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mhni Sleep Medicine PC Current Accepting new patients

Locations

3120 Professional Dr
Ann Arbor, MI 48104
Phone (734) 677-6000

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

Interoperability endpoints

  • Direct secure messaging: smoheyuddin21429@direct.trinity-health.org

Organizations & group practices 2

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1619942596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 PROFESSIONAL DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045131",
            "telephone_number": "734-677-6000",
            "fax_number": "734-677-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 PROFESSIONAL DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045131",
            "telephone_number": "734-677-6000",
            "fax_number": "734-677-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHEYUDDIN",
        "first_name": "SHAMAS",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "4301085148",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MI",
            "license": "4301085148",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4758007",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.