NPIMap

Individual provider Active NPI

Fayez Khader Shamieh, M.D.

  • Neurology Physician
  • Lake Charles, LA
National Provider Identifier
1861582504
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
15000 Issued in LA
Practice address
707 S Ryan St
Lake Charles, LA 70601-5728
Phone
(337) 433-0762
Fax
(337) 433-4868
NPI assigned
Oct 13, 2006
Last updated
Jul 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 15000 LA Primary

Addresses

Primary practice location

707 S Ryan St
Lake Charles, LA 70601-5728

Mailing address

707 S Ryan St
Lake Charles, LA 70601-5728
Phone (337) 433-0762

Other identifiers 1

IdentifierTypeStateIssuer
1191442MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070227000149 LA Practitioner - NeurologyPractitioner - Internal Medicine 2062514722 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fayez K. Shamieh, M.D. a Medical CorporationGroup PAC ID 2961577317, 2 clinicians

Practice addresses (Care Compare)

707 Doctor Michael Debakey Dr
Lake Charles, LA 70601-5728
Phone (337) 433-0762

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15000LAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Department of Health - Office of Public Health Current Accepting new patients
Office of Public Health -Genetics Diseases Program CurrentSince Dec 28, 2018 Accepting new patients
Louisiana Department of Health - Office of Public Health CurrentSince Dec 28, 2018 Accepting new patients
Fayez K. Shamieh, M.D. a Medical Corporation Neurology CurrentSince May 1, 1998 Accepting new patients

Locations

1029 Capitol Ave
Crowley, LA 70526
Phone (337) 788-7507

3236 Kirkman St
Lake Charles, LA 70601
Phone (337) 478-6020

707 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 433-0762

707 Ryan St
Lake Charles, LA 70601
Phone (337) 433-0762

111 N Causeway Blvd
Metairie, LA 70001
Phone (504) 482-0084

1035 Creswell Ave
Shreveport, LA 71101
Phone (318) 676-5222

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
AvalaCovington, LA, CCN 190267 Hospital Operational/Managerial Control Feb 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 11

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1861582504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S RYAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015728",
            "telephone_number": "337-433-0762",
            "fax_number": "337-433-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S RYAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015728",
            "telephone_number": "337-433-0762",
            "fax_number": "337-433-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMIEH",
        "first_name": "FAYEZ",
        "middle_name": "KHADER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "15000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1191442",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.