NPIMap

Individual provider Active NPI

Mohamed M Shahed, MD

  • Internal Medicine Physician
  • Fairview Park, OH
National Provider Identifier
1922075399
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35081431S Issued in OH
Practice address
19050 Lorain Rd
Fairview Park, OH 44126-1915
Phone
(216) 252-8000
Fax
(216) 252-8117
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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 35081431S OH Primary

Addresses

Primary practice location

19050 Lorain Rd
Fairview Park, OH 44126-1915

Mailing address

19050 Lorain Rd
Fairview Park, OH 44126-1915
Phone (216) 252-8000

Other identifiers 12

IdentifierTypeStateIssuer
104899OtherKAISER
D368301OtherGROUP IND DIAGNOSTICS MED
1780634279OtherGROUP NPI
9273172OtherGROUP MEDICARE
CA4511OtherRR MEDICARE GROUP
P00266500OtherRR MEDICARE INDIVIDUAL
0119204OtherGROUP MEDICAID
11212974OtherCCAQH
3610861OtherGROUP ASC MEDICARE
9273172OtherGROUP MEDICAID
1952896250MedicaidOH
2341960MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040305000154 OH Practitioner - Internal MedicinePractitioner - Geriatric MedicinePractitioner - Emergency Medicine 2365330073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19050 Lorain Rd
Fairview Park, OH 44126-1915
Phone (216) 252-8003

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35081431SOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Signature Meds, LLC Internal Medicine CurrentSince Jun 13, 2018 Accepting new patients
Westshore Family Practice Inc Past Accepting new patients
Premier Physicians Centers, Inc Past Accepting new patients

Locations

19050 Lorain Rd
Fairview Park, OH 44126
Phone (216) 252-8000

20455 Lorain Rd
Ste 303
Fairview Park, OH 44126
Phone (216) 227-2194

Interoperability endpoints

  • Direct secure messaging: mshahed94125@direct.ccf.org

Organizations & group practices 4

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 8

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1922075399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19050 LORAIN RD",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441261915",
            "telephone_number": "216-252-8000",
            "fax_number": "216-252-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19050 LORAIN RD",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441261915",
            "telephone_number": "216-252-8000",
            "fax_number": "216-252-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHED",
        "first_name": "MOHAMED",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35081431S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "104899",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP IND DIAGNOSTICS MED",
            "identifier": "D368301",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1780634279",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "9273172",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CA4511",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE INDIVIDUAL",
            "identifier": "P00266500",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "0119204",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCAQH",
            "identifier": "11212974",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ASC MEDICARE",
            "identifier": "3610861",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "9273172",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952896250",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2341960",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Park, OH

Sources for this page

Verify at the official NPI Registry.