Mohammed Saeb Shakir

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-08026 Issued in NC

Practice address

110 Barcelona Dr
Fayetteville, NC 28303-4453

Phone

(800) 243-0566

Fax

(252) 243-1347

NPI assigned

Mar 22, 2018

Last updated

Oct 11, 2022By the provider in NPPES

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 NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Polley Clinic of Dermatology and Dermatologic SurgeryGroup PAC ID 9638134364, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Polley Clinic of Dermatology & Dermatologic Surgery

  • Dermatopathology Physician
  • Wilson, NC
  • NPI 1104847714
  Medicare reassignment Care Compare group
• Haymount Institute for Psychological Services, PLLC

  • Clinical Psychologist
  • Fayetteville, NC
  • NPI 1437320892
  Medicare reassignment
• Haymount Institute for Psychological Services, PLLC

  • Clinical Psychologist
  • Fayetteville, NC
  • NPI 1114490984
  NPD
• Haymount Institute for Psychological Services, PLLC

  • Clinical Psychologist
  • Concord, NC
  • NPI 1316825656

  Physician Assistant

  NPD

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1851895924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 GLENDALE DR SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934402",
            "telephone_number": "800-243-0566",
            "fax_number": "252-243-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BARCELONA DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034453",
            "telephone_number": "800-243-0566",
            "fax_number": "252-243-1347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3516 US Highway 301 S",
            "address_purpose": "LOCATION",
            "city": "Smithfield",
            "state": "NC",
            "postal_code": "275779495",
            "country_code": "US",
            "telephone_number": "800-243-0566",
            "fax_number": "252-243-1347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Barcelona Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283034453",
            "country_code": "US",
            "telephone_number": "800-243-0566",
            "fax_number": "252-243-1347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAKIR",
        "first_name": "MOHAMMED",
        "middle_name": "SAEB",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanjay Shah, M.D.
• Sanjay Bachubhai Shah, MD
• Syeda Zainab Ali Shah, DO
• Matthew Judd Shakespeare, DO
• Hamda Shakil, DPM
• Raniya Shakir
• Mohamed Irrfan Inzamam Shakur, DO
• Kiarash Shams, MD
• Viji Shankar, M.D.
• Mary McCuiston Shapiro

• Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.