NPIMap

Individual provider Active NPI

Faizuddin Shareef, D.O

  • Family Medicine Physician
  • Portage, IN
National Provider Identifier
1891980462
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02003711A Issued in IN
Practice address
2640 Hamstrom Rd
Portage, IN 46368-3832
Phone
(219) 762-4423
NPI assigned
Sep 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02003711A IN Primary

Addresses

Primary practice location

2640 Hamstrom Rd
Portage, IN 46368-3832

Mailing address

2640 Hamstrom Rd
Portage, IN 46368-3832
Phone (219) 762-4423

Other identifiers 1

IdentifierTypeStateIssuer
200990690MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mycare Behavioral Health Inc Current Accepting new patients
The Methodist Hospitals, Inc Past Accepting new patients
Crandon Emergency Physicians LLC PastSince Sep 14, 2025 Accepting new patients
Rend Emergency Physicians Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
The Parkway Hospital Past Accepting new patients
Lifeco Medical, P.C. Past Accepting new patients
Kennekuk Emergency Physicians LLC PastSince Oct 1, 2023 Accepting new patients
Emergency Department Associates, P.C. Past Accepting new patients

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1891980462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 HAMSTROM RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683832",
            "telephone_number": "219-762-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 HAMSTROM RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683832",
            "telephone_number": "219-762-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAREEF",
        "first_name": "FAIZUDDIN",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-07",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003711A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200990690",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.