Individual provider Active NPI

Mohammad Shakir, D.O.

  • Cardiovascular Disease Physician
  • Munster, IN
National Provider Identifier
1932342102
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
02004105A Issued in IN
Practice address
9104 Columbia Ave
Munster, IN 46321-2907
Phone
(198) 364-4732
Fax
(219) 703-6566
NPI assigned
Apr 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036.130352 IL
Cardiovascular Disease Physician 207RC0000X 02004105A IN Primary

Addresses

Primary practice location

9104 Columbia Ave
Munster, IN 46321-2907

Mailing address

8558 Broadway
Merrillville, IN 46410-7032
Phone (219) 392-7084

Other identifiers 1

IdentifierTypeStateIssuer
300062136MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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
I20130618000313 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4587803895 Reassigns benefits to 3 organizations
I20220526001830 IN Practitioner - Cardiovascular Disease (Cardiology) 4587803895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

9104 Columbia Ave
Munster, IN 46321-2907
Phone (219) 836-4473

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.130352ILMDCardiovascular Disease Physician
02004105AINMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince May 1, 2013 Accepting new patients
Lumen Cardiovascular Specialists,LTD Cardiovascular Disease CurrentSince Aug 1, 2015 Accepting new patients
Endeavor Health Medical Group CurrentSince May 1, 2013 Accepting new patients
Community Care Network Inc CurrentSince Jul 1, 2022 Accepting new patients
Elmhurst Memorial Hospital CurrentSince Sep 1, 2015 Accepting new patients

Locations

303 W Lake St
Ste 301
Addison, IL 60101
Phone (331) 221-1650

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

155 E Brush Hill Rd
Elmhurst, IL 60126
Phone (331) 221-3521

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

13963 Morse St
Cedar Lake, IN 46303
Phone (219) 374-2400

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

931 Fran Lin Pkwy
Munster, IN 46321
Phone (219) 513-0107

9104 Columbia Ave
Munster, IN 46321
Phone (219) 836-4473

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

Interoperability endpoints

  • Direct secure messaging: mshakir134166@ssdirect.comhs.org
  • FHIR API: https://api.platform.athenahealth.com/6901/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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 6

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": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1932342102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9104 COLUMBIA AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212907",
            "telephone_number": "198-364-4732",
            "fax_number": "219-703-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKIR",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-16",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036.130352",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "02004105A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300062136",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.