Mustafa Shukr, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

4301101579 Issued in MI

Practice address

23902 Ford Rd Ste a
Dearborn Heights, MI 48127-3289

Phone

(313) 777-7246

Fax

(313) 672-6222

NPI assigned

Sep 11, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Revive Joint and Spine PLLC

  • Interventional Pain Medicine Physician
  • Dearborn Heights, MI
  • NPI 1790611838
  NPD Authorized official

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1952651671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23902 FORD RD STE A",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273289",
            "telephone_number": "313-777-7246",
            "fax_number": "313-672-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23902 FORD RD STE A",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273289",
            "telephone_number": "313-777-7246",
            "fax_number": "313-672-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKR",
        "first_name": "MUSTAFA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-11",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MI",
            "license": "4301101579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chirag Sheth
• Ali Shim
• Sarah Jane Shimazaki, DPH
• Christina Shohatee, NP
• Rabih Shrime
• Ridha Shulabia
• Signature Home Help Services LLC
• Nisreen Silmi
• Silver Oak Home Care LLC
• Mark Sirois, PT

• Interventional Pain Medicine Physician in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Interventional Pain Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.