NPIMap

Individual provider Active NPI

Samir Fayiz Shabshab

  • Nephrology Physician
  • Clinton, MD
National Provider Identifier
1669430823
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
D0037366 Issued in MD
Practice address
8926 Woodyard Rd Ste 602
Clinton, MD 20735-4235
Phone
(301) 868-9414
Fax
(301) 868-6055
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X D0037366 MD Primary
Nephrology Physician 207RN0300X 0101052260 VA

Addresses

Primary practice location

8926 Woodyard Rd Ste 602
Clinton, MD 20735-4235

Mailing address

8926 Woodyard Rd Ste 602
Clinton, MD 20735-4235
Phone (301) 868-9414

Other practice location 1

8101 Hinson Farm Rd Ste 107
Alexandria, VA 22306-3400
Phone (703) 360-3100

Other practice location 2

3261 Old Washington Rd Ste 1020
Waldorf, MD 20602-3228
Phone (301) 868-4326

Other identifiers 1

IdentifierTypeStateIssuer
115640300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20040426001919 DC Practitioner - Nephrology 3971590613 Reassigns benefits to 1 organization
I20181114001177 MD Practitioner - NephrologyPractitioner - Internal Medicine 3971590613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Metropolitan Nephrology Associates PCGroup PAC ID 3971567793, 10 clinicians

Practice addresses (Care Compare)

3261 Old Washington Rd
Suite 1020
Waldorf, MD 20602-3228
Phone (301) 868-4326

8926 Woodyard Rd
Suite 602
Clinton, MD 20735-4235
Phone (301) 868-9414

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0037366MDMDNephrology Physician
0101052260VAMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: sshabshab13939@direct.acumenmd.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1669430823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8926 WOODYARD RD STE 602",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354235",
            "telephone_number": "301-868-9414",
            "fax_number": "301-868-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8926 WOODYARD RD STE 602",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354235",
            "telephone_number": "301-868-9414",
            "fax_number": "301-868-6055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8101 Hinson Farm Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223063400",
            "country_code": "US",
            "telephone_number": "703-360-3100",
            "fax_number": "703-360-6117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3261 Old Washington Rd Ste 1020",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206023228",
            "country_code": "US",
            "telephone_number": "301-868-4326",
            "fax_number": "301-637-3115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHABSHAB",
        "first_name": "SAMIR",
        "middle_name": "FAYIZ",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D0037366",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "VA",
            "license": "0101052260",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115640300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

Verify at the official NPI Registry.