Shadi Maher Koleilat, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

54482 Issued in AZ

Practice address

2450 E River Rd
Tucson, AZ 85718-6526

Phone

(520) 795-7750

NPI assigned

Jun 20, 2013

Last updated

Nov 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Neurology

Education

University of Arizona College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neurological Associates of TucsonGroup PAC ID 5092709527, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Neurological Associates of Tucson

  dba Center for Neurosciences

  • Neurological Surgery Physician
  • Tucson, AZ
  • NPI 1669588158

  Neurology

  Medicare reassignment Care Compare group NPD

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

• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Care Compare affiliation

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1700225919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186526",
            "telephone_number": "520-795-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186526",
            "telephone_number": "520-795-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLEILAT",
        "first_name": "SHADI",
        "middle_name": "MAHER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-20",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "R74122",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "54482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "389563",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alon Kol, D.P.M
• Kola Care, LLC (Right at Home of Southern Arizona)
• Elizabeth Ann Kolbe, PT
• Roy Alan Kolden, CRT
• Margaret Kolega, OTRL
• Elizabeth Lee Koleski, RN
• Jerome Francis Koleski, MD
• Natalie Joy Kollasch, PNP
• Karyn Kolman, MD
• Teresa Lynn Kolodny, LPC LISAC

• Neurology Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Neurology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.

Verify at the official NPI Registry.