Active NPI
Maryann M. Shango, MD
- Hematology & Oncology Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 4301098522
- Practice address
- 250 Cherry St SE
Grand Rapids, MI 49503-4608 - Phone
- (616) 685-5600
- Fax
- (616) 685-6745
- NPI assigned
- May 25, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | MD60739968 | WA | |
| Hematology & Oncology Physician | 207RH0003X | 4301098522 | MI | Primary |
| Hematology & Oncology Physician | 207RH0003X | MD198359 | OR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 4301098522 | MI |
Addresses
Primary practice location
250 Cherry St SE
Grand Rapids, MI 49503-4608
Mailing address
PO Box 776974
Chicago, IL 60677-6974
Phone (616) 685-1808
Other practice location 1
27301 Dequindre Rd Ste 314
Madison Heights, MI 48071-3459
Phone (248) 399-4400
Other practice location 2
12123 SW 69th Ave
Tigard, OR 97223-8514
Phone (971) 708-7600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Wayne State University School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12123 SW 69TH Ave
Tigard, OR 97223-8514
Phone (971) 708-7600
210 SE 136TH Ave
Vancouver, WA 98684-6930
Phone (360) 944-9889
250 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5600
3577 W 13 Mile Rd
Suite 310
Royal Oak, MI 48073-6710
Phone (248) 551-2446
Hospital & facility affiliations
- Beaumont Hospital Royal Oak
- Beaumont Hospital - Farmington Hills
- Mercy Health Saint Mary'S
- Legacy Meridian Park Medical Center
- Providence St Vincent Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60739968 | WA | MD | Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michigan Healthcare Professionals PC | Hematology & Oncology | Current | Accepting new patients |
| Northwest Cancer Specialists, PC | Current | Accepting new patients | |
| Michigan Healthcare Professionals PC | Current | Accepting new patients | |
| William Beaumont Hospital | Past | Accepting new patients |
Locations
27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552
29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430
27301 Dequindre Rd
Ste 314
Madison Hts, MI 48071
Phone (248) 399-4400
1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300
3577 W 13 Mile Rd
Ste 103
Royal Oak, MI 48073
Phone (248) 288-4500
3577 W 13 Mile Rd
Ste 310
Royal Oak, MI 48073
Phone (248) 329-3060
210 SE 136th Ave
Vancouver, WA 98684
Phone (360) 944-9889
1498 SE Tech Center Pl
Ste 240
Vancouver, WA 98683
Phone (360) 597-1309
Interoperability endpoints
- maryann.shango@compass.ikm.direct-ci.com
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Farmington Hills, MI
- NPI 1295023547
Hematology & Oncology
-
- Multi-Specialty Clinic/Center
- Grand Rapids, MI
- NPI 1376862151
-
- Durable Medical Equipment & Medical Supplies
- Lapeer, MI
- NPI 1992693303
-
- Clinical Medical Laboratory
- Vancouver, WA
- NPI 1548506587
-
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
Hospital & facility affiliations 14
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1639111057
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
-
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780012800000",
"number": "1942593876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776974",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776974",
"telephone_number": "616-685-1808",
"fax_number": "312-957-2939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 CHERRY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034608",
"telephone_number": "616-685-5600",
"fax_number": "616-685-6745"
}
],
"practiceLocations": [
{
"address_1": "27301 Dequindre Rd Ste 314",
"address_purpose": "LOCATION",
"city": "Madison Heights",
"state": "MI",
"postal_code": "480713459",
"country_code": "US",
"telephone_number": "248-399-4400",
"fax_number": "248-691-8209",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12123 SW 69th Ave",
"address_purpose": "LOCATION",
"city": "Tigard",
"state": "OR",
"postal_code": "972238514",
"country_code": "US",
"telephone_number": "971-708-7600",
"fax_number": "971-371-5230",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHANGO",
"first_name": "MARYANN",
"middle_name": "M.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-25",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "WA",
"license": "MD60739968",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "MI",
"license": "4301098522",
"primary": true
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "OR",
"license": "MD198359",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4301098522",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.