Individual provider Active NPI

Shahpar Lohuddin, M.D.

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1972951796
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301110035 Issued in MI
Practice address
22101 Moross Rd
Professional Building 2, Suite 50
Detroit, MI 48236-2148
Phone
(313) 343-7784
NPI assigned
Jun 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD17667 RI
Internal Medicine Physician 207R00000X 4301110035 MI Primary

Addresses

Primary practice location

22101 Moross Rd
Professional Building 2, Suite 50
Detroit, MI 48236-2148

Mailing address

25202 Grissom Rd
Laguna Hills, CA 92653-5238
Phone (949) 616-8673

Other practice location 1

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone (401) 921-9202

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20231127001053 NY Practitioner - Diagnostic Radiology 5698068641 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis Cardiac Prevention Services PCGroup PAC ID 4183515836, 60 clinicians
Empire State Radiology P CGroup PAC ID 4385075241, 266 clinicians

Practice addresses (Care Compare)

2200 Northern Blvd
100C St Francis Diagnostic
Greenvale, NY 11548-1220
Phone (516) 325-7400

38 Arbor Field Way
Lake Grove, NY 11755-1837
Phone (718) 223-4685

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD17667RIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Oct 1, 2023 Accepting new patients
St. Francis Cardiac Prevention Services PC Diagnostic Radiology CurrentSince Oct 1, 2023 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Empire State Radiology P C Diagnostic Radiology CurrentSince Jan 8, 2024 Accepting new patients
Bethpage Medical, PLLC Past Accepting new patients
Nrad Medical Associates, PC Internal Medicine Past Accepting new patients

Locations

16303 Horace Harding Expy
Ste 100
Fresh Meadows, NY 11365
Phone (718) 454-4600

2200 Northern Blvd
Ste 118
Greenvale, NY 11548
Phone (516) 563-7910

2200 Northern Blvd
Ste 100C
Greenvale, NY 11548
Phone (516) 325-7400

510 Hicksville Rd
Massapequa, NY 11758
Phone (516) 729-2626

12 N 7th Ave
Mount Vernon, NY 10550
Phone (914) 361-6511

4 Ohio Dr
New Hyde Park, NY 11042
Phone (516) 519-8260

992 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-2910

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

1000 N Village Ave
#13202
Rockville Ctr, NY 11570

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

2500 Nesconset Hwy
Bldg 7D
Stony Brook, NY 11790
Phone (631) 751-3322

12554 Riata Vista Cir
Austin, TX 78727
Phone (512) 519-3462

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1972951796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25202 GRISSOM RD",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535238",
            "telephone_number": "949-616-8673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "address_2": "PROFESSIONAL BUILDING 2, SUITE 50",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-7784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Metro Center Blvd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028861785",
            "country_code": "US",
            "telephone_number": "401-921-9202",
            "fax_number": "401-921-9212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOHUDDIN",
        "first_name": "SHAHPAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-02",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD17667",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301110035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.