Active NPI
Ibrahim S Shamieh, MD
- Gastroenterology Physician
- Standish, MI
National Provider Identifier
1629026463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 4301064684
- Practice address
- 805 West Cedar Street
Standish, MI 48658 - Phone
- (989) 846-3500
- Fax
- (989) 846-3462
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 4301064684 | MI | Primary |
Addresses
Primary practice location
805 West Cedar Street
Standish, MI 48658
Mailing address
PO Box 125
Standish, MI 48658
Phone (989) 846-3500
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P89032 | Other | MI | BCN |
| 4255957 | Medicaid | MI | |
| 0988839 | Other | MI | HEALTH PLUS |
| 3500670651 | Other | MI | BCBSM |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121026000612 | MI | Practitioner - Gastroenterology | 8628228657 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 1983
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
805 W Cedar St PO Box
Suite 125
Standish, MI 48658-0125
Hospital & facility affiliations
- Saint Mary'S Standish Community Hospital
- Tawas St Joseph Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 146 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 81 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Gastroenterology P L L C | Gastroenterology | Current | Accepting new patients |
Locations
805 W Cedar St
Standish, MI 48658
Phone (989) 846-3500
Organizations & group practices 1
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.
-
- Gastroenterology Physician
- Standish, MI
- NPI 1972851608
Gastroenterology, MI
Hospital & facility affiliations 7
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": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280880000000",
"number": "1629026463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 125",
"city": "STANDISH",
"state": "MI",
"postal_code": "48658",
"telephone_number": "989-846-3500",
"fax_number": "989-846-3462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 WEST CEDAR STREET",
"city": "STANDISH",
"state": "MI",
"postal_code": "48658",
"telephone_number": "989-846-3500",
"fax_number": "989-846-3462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAMIEH",
"first_name": "IBRAHIM",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2010-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MI",
"license": "4301064684",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCN",
"identifier": "P89032",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4255957",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS",
"identifier": "0988839",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "3500670651",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Standish, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.