NPIMap

Organization Active NPI

Jawad a Shah, MD PC

  • Specialist
  • Flint, MI
National Provider Identifier
1942402391
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
JAWAD A SHAH, MD PC
Practice address
4800 S Saginaw St
Ste 1805
Flint, MI 48507-2669
Phone
(810) 732-8336
Fax
(810) 239-4346
NPI assigned
Jun 5, 2007
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Dr. Jawad A Shah, MDNPI 1427020452
Title
President
Phone
(810) 732-8336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X MI
Specialist 174400000X MI Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X MI
Neurological Surgery Physician 207T00000X MI
Neuroradiology Physician 2085N0700X MI
Diagnostic Radiology Physician 2085R0202X MI

Addresses

Primary practice location

4800 S Saginaw St
Ste 1805
Flint, MI 48507-2669

Mailing address

4800 S Saginaw St
Ste 1800
Flint, MI 48507-2669
Phone (810) 732-8336

Other practice location 1

24430 Ford Rd
Dearborn Heights, MI 48127-3280
Phone (313) 749-0370

Other practice location 2

21230 Dequindre Rd
Warren, MI 48091-2279
Phone (810) 275-9333

Other practice location 3

5111 Auto Club Dr
Dearborn, MI 48126-2749
Phone (810) 275-9333

Other practice location 4

30800 Van Dyke Ave
Warren, MI 48093-8704
Phone (810) 275-9333

Other identifiers 1

IdentifierTypeStateIssuer
1427020452OtherMIINDIVIDUAL NPI NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040413000798 MI Part B Supplier - Clinic/Group Practice 5799779633 Receives reassigned benefits from 246 practitioners
Practice locations: Dearborn, MI; Flint, MI; Warren, MI

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

4800 S Saginaw St
#1805
Flint, MI 48507

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

Practitioners & affiliated clinicians

Practitioners 250

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 250

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1942402391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 S SAGINAW ST",
            "address_2": "STE 1800",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072669",
            "telephone_number": "810-732-8336",
            "fax_number": "810-239-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 S SAGINAW ST",
            "address_2": "STE 1805",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072669",
            "telephone_number": "810-732-8336",
            "fax_number": "810-239-4346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24430 Ford Rd",
            "address_purpose": "LOCATION",
            "city": "Dearborn Heights",
            "state": "MI",
            "postal_code": "481273280",
            "country_code": "US",
            "telephone_number": "313-749-0370",
            "fax_number": "313-447-2234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21230 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480912279",
            "country_code": "US",
            "telephone_number": "810-275-9333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5111 Auto Club Dr",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481262749",
            "country_code": "US",
            "telephone_number": "810-275-9333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30800 Van Dyke Ave",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480938704",
            "country_code": "US",
            "telephone_number": "810-275-9333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAWAD A SHAH, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "JAWAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-732-8336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1427020452",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.