NPIMap

Individual provider Active NPI

Hassan Shafique, M.D.

  • Internal Medicine Physician
  • Bay St Louis, MS
National Provider Identifier
1972093714
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29091 Issued in MS
Practice address
835 Thames Ave
Bay St Louis, MS 39520-5005
Phone
(228) 466-4977
Fax
(228) 463-0827
NPI assigned
May 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 29091 MS
Internal Medicine Physician 207R00000X 29091 MS Primary

Addresses

Primary practice location

835 Thames Ave
Bay St Louis, MS 39520-5005

Mailing address

PO Box 1810
Gulfport, MS 39502-1810
Phone (228) 575-1194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210823002692 MS Practitioner - Internal Medicine 3476958836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

835 Thames Ave
Bay St Louis, MS 39520-5005
Phone (228) 466-4977

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29091MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Jul 19, 2021 Accepting new patients
Memorial Hospital at Gulfport Internal Medicine CurrentSince Jul 19, 2021 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Biloxi Hma LLC Past Accepting new patients

Locations

835 Thames Ave
Bay St Louis, MS 39520
Phone (228) 466-4977

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

Interoperability endpoints

  • Direct secure messaging: hshafique@direct.mhg.com

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 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1972093714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395021810",
            "telephone_number": "228-575-1194",
            "fax_number": "228-575-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 THAMES AVE",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395205005",
            "telephone_number": "228-466-4977",
            "fax_number": "228-463-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFIQUE",
        "first_name": "HASSAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-17",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "29091",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "29091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay St Louis, MS

Sources for this page

Verify at the official NPI Registry.