BASSAM SYED SHAKIL (NPI# 1790915684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790915684 |
| Entity Type | Individual |
| Full Name | BASSAM SYED SHAKIL |
| Credential | MD |
| Practice Address |
5040 N 15th Ave Ste 107 Phoenix AZ 85015-3329 |
| Mailing Address |
6622 N 91st Ave Ste 220 Glendale AZ 85305-2569 |
| Practice Telephone | 6022009711 |
| Practice Fax Number | 6022009712 |
| Mailing Telephone | 6027596883 |
| Mailing Fax Number | 6022243315 |
| Enumeration Date | 2009-07-25 |
| Last Update Date | 2018-10-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
48780 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 892822 | 05 |
| Street Address |
5040 N 15TH AVE STE 107 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85015-3329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610310 | Leticia Karina Maria Lelli | Student in an Organized Health Care Education/Training Program | 4760 N. 20th Ave, Phx, AZ 85015 | 2020-08-18 |
| 1083100564 | Leen Qutachi | Dentist | 1703 W Bethany Home Rd Ste C1, Phoenix, AZ 85015 | 2018-07-08 |
| 1851820146 | Jeff Biever | Spec/Tech, Cardiovascular | 1517 West Lamar Rd, Phoenix, AZ 85015 | 2017-06-08 |
| 1407230964 | Sean Noonan | Optometrist | 1703 W Bethany Home Rd Ste C3, Phoenix, AZ 85015 | 2015-07-15 |
| 1295141620 | Yehia Saleh | Pharmacist | 4040 North 19th Avenue, Cvs Pharmacy, Phoenix, AZ 85015 | 2014-07-07 |
| 1295160380 | Journey To Prosperity | Custodial Care Facility | 1623 W Denton, Phoenix, AZ 85015 | 2013-09-07 |
| 1124372099 | Facing The Future With Hope | Counselor | 5656 N 17th Ave #c7, Phoenix, AZ 85015 | 2012-10-31 |
| 1700133998 | Srujal Vinubhai Patel | Internal Medicine | 6036 N 19th Ave Ste 312, Phoenix, AZ 85015 | 2012-08-07 |
| 1689933947 | Modern Dental Professionals - Arizona PC | Dentist | 2131 E Camelback Road, Ste 102, Phoenix, AZ 85015 | 2012-05-08 |
| 1528360674 | Fatima Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 2025 W Indian School Road, #705, Phoenix, AZ 85015 | 2010-11-23 |
| Find all providers in zip 85015 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326515677 | Mind Body Kidney | Internal Medicine | 4340 E Indian School Rd Ste 21-408, Phoenix, AZ 85018-5360 | 2018-10-25 |
| 1528427317 | Akdhc, LLC | Internal Medicine | 4901 W Mcdowell Rd, Phoenix, AZ 85035 | 2016-02-22 |
| 1801263033 | Akdhc, LLC | Internal Medicine | 2545 E. Thomas Rd., Suite 110/120, Phoenix, AZ 85016-7941 | 2015-08-24 |
| 1861889859 | Akdhc, LLC | Internal Medicine | 3815 E Bell Rd Ste 3500, Phoenix, AZ 85032-2165 | 2015-04-17 |
| 1730592171 | Joon Soo Kim | Internal Medicine | 9305 W Thomas Rd Ste 570, Phoenix, AZ 85037-3358 | 2014-06-03 |
| 1396064663 | Akdhc, LLC | Internal Medicine | 4524 N Maryvale Parkway, Akdhc, LLC - Maryvale, Ste 160, Phoenix, AZ 85031 | 2010-05-25 |
| 1336338789 | Akdhc, LLC | Internal Medicine | 15255 N 40th St Bldg 5, Phoenix, AZ 85032-4624 | 2007-10-22 |
| 1861681298 | Akdhc, LLC | Internal Medicine | 3003 N Central Ave Ste T100, Phoenix, AZ 85012-2929 | 2007-10-22 |
| 1801084835 | Akdhc, LLC | Internal Medicine | 7725 N 43rd Ave Ste 411, Phoenix, AZ 85051-5771 | 2007-10-03 |
| 1043405301 | Ankur Ashok Patel | Internal Medicine | 9305 W Thomas Rd Ste 255, Phoenix, AZ 85037-3364 | 2007-09-10 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.