Shawn Jeffrey Moulder, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

5101022023 Issued in MI

Practice address

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Phone

(313) 593-7000

NPI assigned

Jun 18, 2015

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

Medicare fee-for-service enrollment

Enrolled in TX, MO, MS, DC, VA5 enrollments

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 5

Specialty

General Surgery

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Specialty Associates of Missouri LLCGroup PAC ID 2860874831, 39 clinicians

Urgent Specialty Associates of Texas PLLCGroup PAC ID 6507258209, 68 clinicians

Urgent Specialty Associates PLLCGroup PAC ID 7618235995, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Houston Healthcare Clear Lake Hospital, Webster, TX, CCN 450617
• Centerpoint Medical Center Hospital, Independence, MO, CCN 260095
• Houston Methodist Clear Lake Hospital Hospital, Nassau Bay, TX, CCN 450709

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Urgent Specialty Associates of Missouri LLC

  • Surgical Critical Care Physician
  • Kansas City, MO
  • NPI 1992436422
  Medicare reassignment Care Compare group NPD
• Urgent Specialty Associates of Texas, PLLC

  • Surgical Critical Care Physician
  • Kingwood, TX
  • NPI 1790350445
  Medicare reassignment Care Compare group NPD
• Urgent Specialty Associates PLLC

  • Surgery Physician
  • Richmond, VA
  • NPI 1487164604

  DC

  Medicare reassignment Care Compare group NPD
• Bon Secours Medical Group Richmond Specialty Care LLC

  • Cardiovascular Disease Physician
  • Richmond, VA
  • NPI 1477112225

  Surgery

  Medicare reassignment NPD
• Urgent Specialty Associates of Mississippi PLLC

  • Surgical Critical Care Physician
  • Tupelo, MS
  • NPI 1972324309
  Medicare reassignment NPD
• Bon Secours Medical Group Richmond Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Midlothian, VA
  • NPI 1841029287
  NPD
• Chca Clear Lake LP

  • General Acute Care Hospital
  • Webster, TX
  • NPI 1063466035
  NPD (past)

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

• Centerpoint Medical Center of Independence, LLC

  • General Acute Care Hospital
  • Independence, MO
  • NPI 1942247044
  Care Compare affiliation
• Chca Clear Lake LP

  • General Acute Care Hospital
  • Webster, TX
  • NPI 1063466035
  Care Compare affiliation
• Houston Methodist St. John Hospital

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1952723967
  Care Compare affiliation

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1770964496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19756 S GLEN BLVD",
            "address_2": "APT C",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481834928",
            "telephone_number": "573-280-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULDER",
        "first_name": "SHAWN",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101022023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Mouabbi, PHARMD
• Mustapha Mouawia
• Zeinab Moubadder, DPM
• Suzan Mouhajer
• Ali Moukdad, PHARMD
• Rabih Mounzer
• Yasmeen Mourad
• Sukaina Mourtada
• Esraa M Mousa
• Kawthar Mousa

• Surgery Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.