NPIMap

Individual provider Active NPI

Shahnaz Ali, M.D.

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1922020478
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301076867 Issued in MI
Practice address
1959 E Paris Ave SE
Grand Rapids, MI 49546-6272
Phone
(616) 808-2695
Fax
(616) 808-2697
NPI assigned
Jul 24, 2006
Last updated
Dec 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301076867 MI Primary

Addresses

Primary practice location

1959 E Paris Ave SE
Grand Rapids, MI 49546-6272

Mailing address

1959 E Paris Ave SE
Grand Rapids, MI 49546-6272
Phone (616) 808-2695

Other identifiers 2

IdentifierTypeStateIssuer
4301076867OtherMISTATE LICENSE
4905354MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20041229000962 MI Practitioner - Internal Medicine 1153389697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Age Management of West Michigan PCGroup PAC ID 2466686290, 23 clinicians
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

1959 E Paris Ave SE
Grand Rapids, MI 49546-6272
Phone (616) 808-2695

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Age Management of West Michigan PC Internal Medicine CurrentSince Oct 15, 2013 Accepting new patients
Porter Hills Home Health West PastSince Jul 24, 2022 Accepting new patients
Covenant Living of the Great Lakes Past Accepting new patients
Platinum Living LLC Past Accepting new patients
Shahnaz Ali, M.D. PLLC Internal Medicine PastSince Jan 1, 1990 Accepting new patients
Age Management and Hormone Balance Center Internal Medicine PastSince Jan 1, 1990 Accepting new patients
Ahsl Holland Operations, LLC Past Accepting new patients
Inpatient Consultants of Michigan PC Internal Medicine Past Accepting new patients
Professional Health Services, PLLC Internal Medicine Past Accepting new patients

Locations

1959 East Paris Ave SE
Grand Rapids, MI 49546
Phone (616) 285-3700

2520 Lake Michigan Dr NW
Grand Rapids, MI 49504
Phone (616) 735-4541

6117 Charlevoix Woods Ct SE
Grand Rapids, MI 49546
Phone (616) 954-2366

3650 Van Buren St
Hudsonville, MI 49426
Phone (616) 669-1520

5980 Eastern Ave SE
Kentwood, MI 49508
Phone (616) 455-7087

11537 Fulton St E
Lowell, MI 49331
Phone (616) 897-8413

350 N Center St
Lowell, MI 49331
Phone (616) 894-8473

1050 4 Mile Rd NW
Walker, MI 49544
Phone (616) 685-7000

Interoperability endpoints

  • Direct secure messaging: sali593@epic00.corewelldirect.org

Organizations & group practices 10

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 9

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1922020478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466272",
            "telephone_number": "616-808-2695",
            "fax_number": "616-808-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466272",
            "telephone_number": "616-808-2695",
            "fax_number": "616-808-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "SHAHNAZ",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301076867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301076867",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4905354",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.