NPIMap

Individual provider Active NPI

Khaled Shafiei, MD

  • Family Medicine Physician
  • Monroe, LA
National Provider Identifier
1922034487
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
026713 Issued in LA
Practice address
3510 Medical Park Dr.
Suite 9
Monroe, LA 71203
Phone
(318) 388-6050
Fax
(318) 998-3022
NPI assigned
Jun 24, 2006
Last updated
Sep 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 026713 LA
Family Medicine Physician 207Q00000X 026713 LA Primary

Addresses

Primary practice location

3510 Medical Park Dr.
Suite 9
Monroe, LA 71203

Mailing address

3510 Medical Park Dr.
Suite 9
Monroe, LA 71203
Phone (318) 388-6050

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
I20031230000100 LA Practitioner - Family Practice 0143128074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine of the Twin CitiesGroup PAC ID 4789671470, 4 clinicians

Practice addresses (Care Compare)

2503 Broadmoor Blvd
Monroe, LA 71201-2987
Phone 318388605012

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.25 of 100Reported as group
Quality
87.55
Improvement activities
40
Cost
64.1

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026713LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine of the Twin Cities CurrentSince Mar 9, 2007 Accepting new patients
Hospitalist Group of Northeast Louisiana Past Accepting new patients
Landmark Nursing Center of West Monroe LLC Past Accepting new patients
CHG Hospital West Monroe, LLC Past Accepting new patients
Avalon Place, LP Past Accepting new patients
Sciometrix Inc Past Accepting new patients
Vista Specialty Hospital of West Monroe LLC Past Accepting new patients
Southern Acres Care Center, LP Past Accepting new patients

Locations

2503 Broadmoor Blvd
Monroe, LA 71201
Phone (318) 322-7726

3510 Medical Park Dr
Ste 9
Monroe, LA 71203
Phone (318) 388-6050

Interoperability endpoints

  • Direct secure messaging: internalmedicineofthetwincities.khaledshafiei@118405.advancedmd-direct.com
  • Direct secure messaging: kshafiei16309@direct.casso.us.com

Organizations & group practices 8

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 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1922034487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 MEDICAL PARK DR.",
            "address_2": "SUITE 9",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71203",
            "telephone_number": "318-388-6050",
            "fax_number": "318-998-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 MEDICAL PARK DR.",
            "address_2": "SUITE 9",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71203",
            "telephone_number": "318-388-6050",
            "fax_number": "318-998-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFIEI",
        "first_name": "KHALED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "026713",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "026713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.