Active NPI
Sohaip Mohammad Shafeeq Kabashneh, M.D
- Student in an Organized Health Care Education/Training Program
- Worcester, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 55 Lake Ave N
Worcester, MA 01655-0002 - Phone
- (508) 334-1131
- NPI assigned
- May 1, 2018
- Reactivated
- Dec 31, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary | ||
| Hematology & Oncology Physician | 207RH0003X | 13658669-1205 | UT |
Addresses
Primary practice location
55 Lake Ave N
Worcester, MA 01655-0002
Mailing address
55 Lake Ave N
Worcester, MA 01655-0002
Other practice location 1
1034 N 500 W
Provo, UT 84604-3337
Phone (248) 890-4995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hematology/Oncology
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1034 N 500
Provo, UT 84604-3380
Phone (801) 357-8879
170 N 1100
American Fork, UT 84003-2096
Phone (801) 357-7414
700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119
Interoperability endpoints
- sohaip.kabashneh.1@13014.direct.athenahealth.com
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
dba St George Adolescent Partial Hospitalization
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
dba Orem Community Hospital Physicians
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Intermountain Health Utah Valley Hospital
- General Acute Care Hospital
- Provo, UT
- NPI 1114025491
-
dba Intermountain Health Infusion Center- Spanish Fork, A Service of Utah Valley Hospital
- Infusion Therapy Clinic/Center
- Spanish Fork, UT
- NPI 1679426944
Hospital
-
dba Intermountain Health American Fork Hospital
- General Acute Care Hospital
- American Fork, UT
- NPI 1912014358
-
dba Intermountain Health Infusion Center- American Fork, A Service of Utah Valley Hospital
- Infusion Therapy Clinic/Center
- American Fork, UT
- NPI 1982557252
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707696000000",
"number": "1629566054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "508-334-1131"
}
],
"practiceLocations": [
{
"address_1": "1034 N 500 W",
"address_purpose": "LOCATION",
"city": "Provo",
"state": "UT",
"postal_code": "846043337",
"country_code": "US",
"telephone_number": "248-890-4995",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KABASHNEH",
"first_name": "SOHAIP",
"middle_name": "MOHAMMAD SHAFEEQ",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-01",
"last_updated": "2024-02-12",
"certification_date": "2024-02-12",
"deactivation_date": "2018-12-13",
"reactivation_date": "2018-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "UT",
"license": "13658669-1205",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.