Active NPI
Shoaib Shafique, M.D.
- Vascular Surgery Physician
- Lafayette, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 01054771A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200392330A | Medicaid | IN |
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
Enrollment records 1
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
Practice addresses (Care Compare)
3900 St Francis Way
Suite 201
Lafayette, IN 47905-4925
Phone (765) 400-0204
Hospital & facility affiliations
- Franciscan Health Lafayette
- Franciscan Health Crawfordsville
- Franciscan Health Rensselaer, Inc
- Franciscan Health Indianapolis
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 23 |
| Leg revascularization (restoring blood flow) | 31 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01054771A | IN | MD | Vascular Surgery Physician |
| 26123 | OK | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unity Healthcare, LLC | Current | Accepting new patients | |
| Unity Healthcare LLC | Vascular Surgery | Current | 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
- 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.
-
- Clinic/Center
- Lafayette, IN
- NPI 1619929098
-
- Vascular Surgery Physician
- Lafayette, IN
- NPI 1427759182
-
- Surgery Physician
- Indianapolis, IN
- NPI 1316966229
-
- Vascular Surgery Physician
- Indianapolis, IN
- NPI 1043328487
-
- Emergency Medicine Physician
- Cottonwood, AZ
- NPI 1598714743
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Crawfordsville, IN
- NPI 1588774558
-
- General Acute Care Hospital
- Carmel, IN
- NPI 1376214981
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1386749893
-
- General Acute Care Hospital
- Lafayette, IN
- NPI 1356435341
-
- Critical Access Hospital
- Rensselaer, IN
- NPI 1932589173
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.