Husam Shadid, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

4301513352 Issued in MI

Practice address

205 N East Ave
Jackson, MI 49201-1753

Phone

(517) 205-4800

NPI assigned

Jun 23, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, MI2 enrollments

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 2

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Memorial Hermann Medical Group

  • Family Medicine Physician
  • Fulshear, TX
  • NPI 1003985102

  Internal Medicine

  Medicare reassignment NPD
• Jackson Heart PLLC

  • Interventional Cardiology Physician
  • Jackson, MI
  • NPI 1164353009
  NPD Authorized official
• Wa Foote Memorial Hospital, Inc

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment
• Ascension Medical Group Promed

  • Family Medicine Physician
  • Portage, MI
  • NPI 1497709869

  Internal Medicine

  NPD (past)

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

• Ascension Borgess Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Care Compare affiliation

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

{
    "created_epoch": "1561248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1992366801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6410 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770303000",
            "country_code": "US",
            "telephone_number": "832-325-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6411 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301501",
            "country_code": "US",
            "telephone_number": "713-500-7116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHADID",
        "first_name": "HUSAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-23",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "U4005",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U4005",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301513352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Scott Severance, DC
• Moriah K Severance, DC
• Misty Sewell
• Omar Suhail Shabandri, MD
• Wardha Shabbir, MD
• Scarlet Shaffer, MA, CCC-SLP
• Heather Shafley
• Bhavna Rajesh Shah, MD
• Rajesh Punjalal Shah, MD
• Sapna Shah

• Cardiovascular Disease Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.

Verify at the official NPI Registry.