Mohedine Shafei, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-24613 Issued in KS

Practice address

106 Willow Rd
Goodland, KS 67735-1518

Phone

(785) 890-6075

Fax

(785) 890-6077

NPI assigned

Jul 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KS

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

Emergency Medicine

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innova Emergency Medical Associates PCGroup PAC ID 2860633435, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwest Medical Center Hospital, Liberal, KS, CCN 170068

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 and National Provider Directory roles.

• Innova Emergency Medical Associates PC

  • Emergency Medicine Physician
  • Trinidad, CO
  • NPI 1295178978

  KS

  Medicare reassignment Care Compare group NPD
• Goodland Regional Medical Center

  • Critical Access Hospital Clinic/Center
  • Goodland, KS
  • NPI 1447392451
  NPD (past)
• Southwest Medical Center

  • General Acute Care Hospital
  • Liberal, KS
  • NPI 1538109251
  NPD (past)
• Midwest Medical Management, P.C.

  • Emergency Medicine Physician
  • Terre Haute, IN
  • NPI 1417996430
  NPD (past)

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

• Southwest Medical Center

  • General Acute Care Hospital
  • Liberal, KS
  • NPI 1538109251

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1770580425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 WILLOW RD",
            "city": "GOODLAND",
            "state": "KS",
            "postal_code": "677351518",
            "telephone_number": "785-890-6075",
            "fax_number": "785-890-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WILLOW RD",
            "city": "GOODLAND",
            "state": "KS",
            "postal_code": "677351518",
            "telephone_number": "785-890-6075",
            "fax_number": "785-890-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFEI",
        "first_name": "MOHEDINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-24613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100147300B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTGUARD",
            "identifier": "645460",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kali Rubenthaler-Brunkhardt, DO
• Tamera D Sanderson, PTA
• Nathan Schmidt, DDS
• Amy Rose Schulte, CCC-SLP
• Brittany Sexson, PTA
• Sherman County
• Douglas Paul Simon, PA-C
• Paula Jean Sisler, R.PH.
• Sondra Krayca, a.R.N.P., LLC
• Autumn Jade Spellmeier, APRN

• Family Medicine Physician in Goodland, KS
• Providers in Goodland, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.