Individual provider Active NPI

Walid Labib Shaib, M.D.

  • Hematology & Oncology Physician
  • New Haven, CT
National Provider Identifier
1831372481
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
068617 Issued in GA
Practice address
1450 Chapel St
Hospital of Saint Raphael
New Haven, CT 06511-4405
Phone
(203) 789-3034
Fax
(203) 789-5184
NPI assigned
Dec 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 068617 GA Primary

Addresses

Primary practice location

1450 Chapel St
Hospital of Saint Raphael
New Haven, CT 06511-4405

Mailing address

1450 Chapel St
Hospital of Saint Raphael
New Haven, CT 06511-4405
Phone (203) 789-3034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140630000450 GA Practitioner - Hematology/Oncology 0042334898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1810 White Cir
Suite 105
Marietta, GA 30066-5836
Phone (678) 797-6820

2540 Windy Hill Rd
Marietta, GA 30067-8605
Phone (770) 644-1570

2540 Windy Hill Serd
Marietta, GA 30067-8605
Phone (770) 644-1274

2550 Windy Hill Rd SE
Suite 220
Marietta, GA 30067-8605
Phone (404) 321-9900

340 Kennestone Hospital Blvd
Suite 100
Marietta, GA 30060-1158
Phone (770) 281-5100

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022

5 Cloverleaf Dr
Cartersville, GA 30120-2177
Phone (770) 386-7253

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
068617GAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2022 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2022 Accepting new patients
Saint Raphael Faculty Physicians Internal Medicine Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

Interoperability endpoints

  • Direct secure messaging: wshaib451590@directwellstar.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1831372481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 CHAPEL ST",
            "address_2": "HOSPITAL OF SAINT RAPHAEL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114405",
            "telephone_number": "203-789-3034",
            "fax_number": "203-789-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CHAPEL ST",
            "address_2": "HOSPITAL OF SAINT RAPHAEL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114405",
            "telephone_number": "203-789-3034",
            "fax_number": "203-789-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIB",
        "first_name": "WALID",
        "middle_name": "LABIB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-06",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "068617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.