Individual provider Active NPI

Shahid Shamim, MD

  • Internal Medicine Physician
  • Rockville, MD
National Provider Identifier
1932208543
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D-59284 Issued in MD
Practice address
11119 Rockville Pike
Suite 100
Rockville, MD 20852-3143
Phone
(301) 452-2116
Fax
(240) 454-3980
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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 D-59284 MD Primary

Addresses

Primary practice location

11119 Rockville Pike
Suite 100
Rockville, MD 20852-3143

Mailing address

PO Box 10247
Gaithersburg, MD 20898-0247
Phone (301) 452-2116

Other identifiers 2

IdentifierTypeStateIssuer
015238C82OtherMDMEDICARE
400656900MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040727000126 DC Practitioner - Internal MedicinePractitioner - Geriatric Medicine 9537149935 Reassigns benefits to 2 organizations
I20150716001593 MD Practitioner - Internal Medicine 9537149935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians

Practice addresses (Care Compare)

11119 Rockville Pike
Suite 101
Rockville, MD 20852-3143
Phone (301) 881-5585

4910 Massachusetts Ave NW
Suite 114 Grady DC Office
Washington, DC 20016-4384
Phone (202) 686-0813

6410 Rockledge Dr
Bethesda, MD 20817-1844

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D-59284MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Care Center LLC Internal Medicine CurrentSince Oct 4, 2018 Accepting new patients
Privia Medical Group, LLC Internal Medicine CurrentSince May 21, 2015 Accepting new patients
Capitol Cardiology Associates, LLC Current Accepting new patients
Privia Medical Group, LLC CurrentSince May 21, 2015 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Oct 4, 2018 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4910 Massachusetts Ave NW
Ste 114
Washington, DC 20016
Phone (202) 244-0812

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

11119 Rockville Pike
Ste 101
Rockville, MD 20852
Phone (301) 881-5585

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

7600 Carroll Ave
Takoma Park, MD 20912
Phone (301) 791-7600

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: shahid.shamim.1@8042.direct.athenahealth.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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1932208543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10247",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208980247",
            "telephone_number": "301-452-2116",
            "fax_number": "240-454-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11119 ROCKVILLE PIKE",
            "address_2": "SUITE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523143",
            "telephone_number": "301-452-2116",
            "fax_number": "240-454-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMIM",
        "first_name": "SHAHID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D-59284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "015238C82",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400656900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.