Syed Ali Shan Idris, M.D.; MBBS

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

35.087057 Issued in OH

Practice address

5965 Easy Broad Street, Suite 260
Columbus, OH 43213

Phone

(641) 866-3703

Fax

(614) 866-6109

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Specialty

NeurologyAlso: Internal Medicine

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mount Carmel Healthproviders Two LLCGroup PAC ID 6608828447, 222 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Carmel East & West Hospital, Columbus, OH, CCN 360035
• Mount Carmel St Ann'S Hospital, Westerville, OH, CCN 360012
• Mount Carmel New Albany Surgical Hospital Hospital, New Albany, OH, CCN 360266
• Diley Ridge Medical Center Hospital, Canal Winchester, OH, CCN 360358
• Mount Carmel Dublin Hospital, Dublin, OH, CCN 360375

Merit-based Incentive Payment System (MIPS)

Final score

79.44 of 100Reported as group

Quality

75.57

Promoting interoperability

79

Improvement activities

40

Cost

73.41

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aidris1153616@direct.trinity-health.org
• Direct secure messaging: sidris393380@ehrdirect.uhhospitals.org

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.

• Mount Carmel Healthproviders Two LLC

  • Cardiovascular Disease Physician
  • Columbus, OH
  • NPI 1134154750

  Neurology

  Medicare reassignment Care Compare group NPD
• Mount Carmel Healthproviders Two LLC

  • Surgery Physician
  • Columbus, OH
  • NPI 1528203981
  NPD

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

• Diley Ridge Medical Center

  • General Acute Care Hospital
  • Canal Winchester, OH
  • NPI 1225361181
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Westerville, OH
  • NPI 1417037045
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Grove City, OH
  • NPI 1710067376
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Dublin, OH
  • NPI 1710752183
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • New Albany, OH
  • NPI 1770668568
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1982784534
  Care Compare affiliation

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1942317060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 E BROAD ST STE 260",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131562",
            "telephone_number": "641-866-3703",
            "fax_number": "614-866-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 EASY BROAD STREET, SUITE 260",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43213",
            "telephone_number": "641-866-3703",
            "fax_number": "614-866-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDRIS",
        "first_name": "SYED ALI SHAN",
        "credential": "M.D.; MBBS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35087057",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35087057",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35.087057",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.087057",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.087057",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2697489",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00352662",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000494609",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ideal Medical Supply Inc
• Ideal Medical Supply Inc
• Alyssa Emani Ideis, CDCA
• Racheal Idowu
• Sumer Idries, LISW
• Brima Idriss
• Gberrah Roy Idriss, RN
• John Gerard Idzakovich Jr., NNP
• Madison A Ielase
• If My People Imp LLC

• Neurology Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Neurology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.