Individual provider Active NPI

Raafat Boles Mahrous Shehata, M.D.

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1891078846
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301099522 Issued in MI
Practice address
21540 W 11 Mile Rd Ste 200
Southfield, MI 48076-3843
Phone
(248) 352-2000
Fax
(248) 352-8800
NPI assigned
Sep 26, 2011
Last updated
Oct 31, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 4301099522 MI
Family Medicine Physician 207Q00000X 4301099522 MI Primary

Addresses

Primary practice location

21540 W 11 Mile Rd Ste 200
Southfield, MI 48076-3843

Mailing address

PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6060

Other practice location 1

18463 Livernois Ave
Detroit, MI 48221-2254
Phone (313) 861-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120220000666 MI Practitioner - Family PracticePractitioner - Geriatric MedicinePractitioner - General Practice 7911165139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice, Geriatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

15959 Hall Rd
Suite 104
Macomb, MI 48044-5364
Phone (586) 884-2688

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.04 of 100Reported as group
Quality
67.93
Promoting interoperability
100
Improvement activities
40
Cost
52.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301099522MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Primary Care II PLLC Family Medicine CurrentSince Jun 4, 2018 Accepting new patients
Wellstreet Urgent Care of Michigan CurrentSince Oct 1, 2020 Accepting new patients
Mid Michigan Home Visiting Doctors LLC General Practice CurrentSince Jul 3, 2012 Accepting new patients
Advanced Care Medical Center Inc Family Medicine Past Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients
Az Medical Services Management LLC General Practice Past Accepting new patients
Biogenetics Laboratories, Inc. Past Accepting new patients

Locations

18254 Livernois Ave
Ste 1
Detroit, MI 48221
Phone 24833640008001

15959 Hall Rd
Ste 104
Macomb, MI 48044
Phone (586) 884-2688

640 Romence Rd
Ste 215
Portage, MI 49024
Phone (269) 321-3300

2007 E 14 Mile Rd
Sterling Heights, MI 48310
Phone (313) 740-1111

2078 E Big Beaver Rd
Troy, MI 48083
Phone (248) 855-4134

Interoperability endpoints

  • Direct secure messaging: rshehata557435@direct.hfhs.org

Organizations & group practices 7

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 3

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": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1891078846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239",
            "telephone_number": "248-824-6060",
            "fax_number": "248-686-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21540 W 11 MILE RD STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763843",
            "telephone_number": "248-352-2000",
            "fax_number": "248-352-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18463 Livernois Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482212254",
            "country_code": "US",
            "telephone_number": "313-861-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEHATA",
        "first_name": "RAAFAT",
        "middle_name": "BOLES MAHROUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-26",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301099522",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301099522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.