Individual provider Active NPI

Sidra Shah Elia, M.D.

  • Internal Medicine Physician
  • Wayne, MI
National Provider Identifier
1730580259
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301106403 Issued in MI
Practice address
33155 Annapolis St
Wayne, MI 48184-2405
Phone
(734) 467-4000
Fax
(734) 467-4017
NPI assigned
Sep 16, 2014
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301106403 MI Primary

Addresses

Primary practice location

33155 Annapolis St
Wayne, MI 48184-2405

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1863

Other names 1

  • Sidra Shah Shah Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address selia1840516@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190306000739 MI Practitioner - Internal Medicine 0840539037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians

Practice addresses (Care Compare)

33155 Annapolis St
Wayne, MI 48184-2405
Phone (734) 467-4234

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187

44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111

468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (313) 473-1605

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Inpatient Physicians-Michigan, PLLC Internal Medicine CurrentSince Jan 28, 2019 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC Internal Medicine CurrentSince Jan 28, 2019 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Jan 31, 2021 Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients

Locations

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

800 S Washington Ave
Saginaw, MI 48601
Phone (989) 776-8000

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Interoperability endpoints

  • Direct secure messaging: selia1232524@epic00.shdirect.org

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

Hospital & facility affiliations 3

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": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1730580259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1863",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33155 ANNAPOLIS ST",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842405",
            "telephone_number": "734-467-4000",
            "fax_number": "734-467-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIA",
        "first_name": "SIDRA",
        "middle_name": "SHAH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301106403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "selia1840516@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "33155 Annapolis St",
            "city": "Wayne",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481842405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SIDRA",
            "last_name": "SHAH",
            "middle_name": "SHAH",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wayne, MI

Sources for this page

Verify at the official NPI Registry.