NPIMap

Individual provider Active NPI

Abdussalam Shredi, MD

  • Internal Medicine Physician
  • Lubbock, TX
National Provider Identifier
1649727827
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53066 Issued in KY
Practice address
3601 4TH St
Ms 9410
Lubbock, TX 79430-0002
Phone
(806) 743-3150
Fax
(806) 743-2893
NPI assigned
Sep 6, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 53066 KY Primary

Addresses

Primary practice location

3601 4TH St
Ms 9410
Lubbock, TX 79430-0002

Mailing address

3601 4TH St
Ms 9410
Lubbock, TX 79430-0002
Phone (806) 743-3150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190724002533 TX Practitioner - Internal Medicine 7416245808 Reassigns benefits to 3 organizations
I20200220000905 KY Practitioner - Internal Medicine 7416245808 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

1 Saint Joseph Dr
Lexington, KY 40504-3742
Phone (859) 313-1000

150 N Eagle Creek Dr
Lexington, KY 40509-1805
Phone (859) 967-5000

217 S 3Rd St
Danville, KY 40422-1823
Phone (859) 239-5008

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
77.5
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53066KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Cogent Healthcare of Kentucky, PSC Internal Medicine CurrentSince Jan 5, 2020 Accepting new patients
Sound Inpatient Physicians of Texas I, Inc Internal Medicine CurrentSince Jan 17, 2020 Accepting new patients
Hospitalist Medicine Physicians of Indiana, LLC Internal Medicine CurrentSince May 19, 2021 Accepting new patients
24 On Physicians, PC CurrentSince Jun 15, 2022 Accepting new patients
24 On Physicians, P.C. CurrentSince Jun 15, 2022 Accepting new patients
Sound Inpatient Physicians of Texas I, Inc Internal Medicine Current Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Sound Inpatient Physicians of Texas I, Inc Internal Medicine CurrentSince Jan 17, 2020 Accepting new patients
Ephraim McDowell Regional Medical Center Incorporated Past Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Covenant Medical Group Internal Medicine Past Accepting new patients

Locations

217 S 3rd St
Danville, KY 40422
Phone (859) 239-1000

1 Saint Joseph Dr
Lexington, KY 40504
Phone (502) 350-5000

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

1001 Saint Joseph Ln
London, KY 40741
Phone (606) 330-6000

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

3615 19th St
Lubbock, TX 79410
Phone (806) 725-0000

2601 Dimmitt Rd
Plainview, TX 79072
Phone (806) 296-4282

17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 12

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1649727827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "MS 9410",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-3150",
            "fax_number": "806-743-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "MS 9410",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-3150",
            "fax_number": "806-743-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHREDI",
        "first_name": "ABDUSSALAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-06",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "53066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.