Mohammad Shamshuddin, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036091936 Issued in IL

Practice address

6703 159TH St
Suite 103
Tinley Park, IL 60477-1781

Phone

(708) 342-3000

Fax

(708) 342-3060

NPI assigned

Jul 28, 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 3

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

Specialty

Internal Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ucm Medical Group Sub LLCGroup PAC ID 4688635337, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ingalls Home Care Inc. Home health agency, Harvey, IL, CCN 147435
• Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191
• The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mshamshuddin179489@uchospital.direct-ci.com

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.

• Ucm Medical Group Sub, LLC

  • Family Medicine Physician
  • Harvey, IL
  • NPI 1467442293

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Endocrine Care LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Tinley Park, IL
  • NPI 1710931555
  NPD (past)
• Primary Care Partners LLC

  • Internal Medicine Physician
  • Tinley Park, IL
  • NPI 1376533380
  NPD (past)
• Surgical Specialists, SC

  • Specialist
  • Palos Heights, IL
  • NPI 1720201320
  NPD (past)

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

• Ingalls Memorial Hospital

  • General Acute Care Hospital
  • Harvey, IL
  • NPI 1598756686
  Care Compare affiliation
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1508956509
  Care Compare affiliation
• Ucm Home Care

  • Home Health Agency
  • Harvey, IL
  • NPI 1417998865
  Care Compare affiliation

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1801896261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27702 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731277",
            "telephone_number": "708-862-7674",
            "fax_number": "708-862-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6703 159TH ST",
            "address_2": "SUITE 103",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771781",
            "telephone_number": "708-342-3000",
            "fax_number": "708-342-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMSHUDDIN",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036091936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091936",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "231199006",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "P00760031",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Faten Shaabneh, PT
• Ravi M. Shah
• Hany Shahin, DPM
• Sanah Shaikh, M.D.
• Sara Shakhwar, PHARMD
• Brielle Shapiro, HIS
• Malika Sharma, OD
• Sunita Sharma, MOTR/L
• Assata Sharrieff
• Roslyn Marie Shaw, OT

• Internal Medicine Physician in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.