Individual provider Active NPI

Shahed Yunus Ghoghawala, MD

  • Ophthalmology Physician
  • Madison, WI
National Provider Identifier
1871768051
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
54016 Issued in WI
Practice address
1025 Regent St
Madison, WI 53715-1248
Phone
(608) 282-2000
Fax
(608) 282-2172
NPI assigned
Apr 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X P5806 TX
Cornea and External Diseases Specialist Physician 207WX0120X P5806 TX
Ophthalmology Physician 207W00000X 54016 WI Primary

Addresses

Primary practice location

1025 Regent St
Madison, WI 53715-1248

Mailing address

1025 Regent St
Madison, WI 53715-1248
Phone (608) 282-2000

Other practice location 1

5402 S Staples St
Suite 100
Corpus Christi, TX 78411-4670
Phone (361) 906-3567

Other identifiers 1

IdentifierTypeStateIssuer
1871768051MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sghoghawala511712@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240605000466 WI Practitioner - Ophthalmology 6406019439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

1025 Regent St
Madison, WI 53715-1248
Phone (608) 282-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery297

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54016WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc. CurrentSince May 23, 2024 Accepting new patients
Dean Health Systems, Inc CurrentSince May 23, 2024 Accepting new patients

Locations

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

1025 Regent St
Madison, WI 53715
Phone (608) 282-2000

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: sghoghawala511712@direct-ehr-ssmhc.com
  • Direct secure messaging: ghoghawala@stec.direct.iopracticeware.com

Organizations & group practices 2

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 2

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": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1871768051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 REGENT ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151248",
            "telephone_number": "608-282-2000",
            "fax_number": "608-282-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 REGENT ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151248",
            "telephone_number": "608-282-2000",
            "fax_number": "608-282-2172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5402 S Staples St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784114670",
            "country_code": "US",
            "telephone_number": "361-906-3567",
            "fax_number": "361-906-3599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHOGHAWALA",
        "first_name": "SHAHED",
        "middle_name": "YUNUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "P5806",
            "primary": false
        },
        {
            "code": "207WX0120X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": "TX",
            "license": "P5806",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "54016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871768051",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sghoghawala511712@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sghoghawala511712@direct-ehr-ssmhc.com",
            "address_1": "1025 Regent St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151248",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1025 Regent St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.