Individual provider Active NPI

Shoaib Shafique, M.D.

  • Vascular Surgery Physician
  • Lafayette, IN
National Provider Identifier
1851357669
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
01054771A Issued in IN
Practice address
3900 St Francis Way Ste 201
Lafayette, IN 47905-4925
Phone
(765) 446-7981
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 26123 OK
Vascular Surgery Physician 2086S0129X 01054771A IN Primary

Addresses

Primary practice location

3900 St Francis Way Ste 201
Lafayette, IN 47905-4925

Mailing address

3900 St Francis Way Ste 201
Lafayette, IN 47905-4925

Other practice location 1

8433 Harcourt Road
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

Other identifiers 1

IdentifierTypeStateIssuer
200392330AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040401000130 IN Practitioner - Vascular Surgery 8628060480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unity Healthcare LLCGroup PAC ID 0244123362, 62 clinicians

Practice addresses (Care Compare)

3900 St Francis Way
Suite 201
Lafayette, IN 47905-4925
Phone (765) 400-0204

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal23
Leg revascularization (restoring blood flow)31
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01054771AINMDVascular Surgery Physician
26123OKMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Healthcare, LLC Current Accepting new patients
Unity Healthcare LLC Vascular Surgery CurrentSince Apr 1, 2023 Accepting new patients
Willard Emergency Physicians Past Accepting new patients
University Surgeons, Inc. Past Accepting new patients
University Vascular Surgery, Inc Vascular Surgery Past Accepting new patients

Locations

3900 St Francis Way
Ste 201
Lafayette, IN 47905
Phone (765) 400-0204

1345 Unity Pl
Ste 235
Lafayette, IN 47905
Phone (765) 446-5065

Interoperability endpoints

  • Direct secure messaging: sshafique107160@direct.franciscanalliance.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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1851357669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 ST FRANCIS WAY STE 201",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 ST FRANCIS WAY STE 201",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054925",
            "telephone_number": "765-446-7981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8433 Harcourt Road",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462602193",
            "country_code": "US",
            "telephone_number": "317-583-7600",
            "fax_number": "317-583-7601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFIQUE",
        "first_name": "SHOAIB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OK",
            "license": "26123",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01054771A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200392330A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.