Individual provider Active NPI

Anthony M Shadid, MD

  • Diagnostic Radiology Physician
  • Madison, WI
National Provider Identifier
1730127275
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
49297 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-0001
Phone
(608) 263-8340
Fax
(608) 833-6932
NPI assigned
Jun 4, 2006
Last updated
Jul 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 49297 WI Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-0001

Mailing address

8007 Excelsior Dr
Madison, WI 53717-1962
Phone (608) 829-5238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20070817000029 IL Practitioner - Diagnostic Radiology 6709880925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialists in Medical Imaging SCGroup PAC ID 2163733544, 228 clinicians

Practice addresses (Care Compare)

13214 N River Beach Dr
Chillicothe, IL 61523-9298
Phone (309) 671-8282

1800 Broadway St
Pekin, IL 61554-3822
Phone (309) 671-8282

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 671-8282

2338 W Van Winkle Way
Peoria, IL 61615-7483
Phone (309) 671-8282

600 S 13TH St
Pekin, IL 61554-4936
Phone (309) 671-8282

8914 N Knoxville Ave
Peoria, IL 61615-1410
Phone (309) 671-8282

8940 N Wood Sage Rd
Peoria, IL 61615-7822
Phone (309) 671-8282

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49297WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialists in Medical Imaging SC Diagnostic Radiology CurrentSince Jun 1, 2015 Accepting new patients
Cira Michigan PC Diagnostic Radiology Past Accepting new patients

Locations

2000 Spring Rd
Ste 200
Oak Brook, IL 60523
Phone (630) 472-8810

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

Organizations & group practices 2

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 4

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1730127275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8007 EXCELSIOR DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171962",
            "telephone_number": "608-829-5238",
            "fax_number": "608-833-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-263-8340",
            "fax_number": "608-833-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADID",
        "first_name": "ANTHONY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "49297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.