Deactivated NPI 1114928199 Deactivated / Inactive NPI Male Practitioner

Dr. Kenneth W Shaheen , MD

Specialist • Troy, MI

✓ Accepts Medicare Assignment

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kenneth Shaheen has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 02, 2005

NPI Deactivation Date March 21, 2006

Total Practice Duration ~23 Years of Practice (1983 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Shaheen, MD was a registered Specialist in Troy, MI. Prior to record deactivation on 2006-03-21, Dr. Shaheen completed approximately 23 years of clinical practice following graduation from Wayne State University School Of Medicine in 1983.

Dr. Shaheen accepted Medicare assignment.

Historical Medicare Part B clinical services included new patient outpatient office visit, established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

2585 Crooks Rd

Troy, MI 480844702

Telephone 2482831110

Fax 2482831114

Associated Practice Facility / Clinic

🏢 Kenneth W. Shaheen, M.d.,p.c. Facility NPI 1093987927

Medicare Profile & Education

Medical School

Wayne State University School Of Medicine

Graduation Year

1983

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Troy, MI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

43 Yrs -1.4 yrs vs City Avg

City Avg: 44.4 Yrs

State Avg: 37.1 Yrs

Regional Practice Density

7 Specialists

Practicing in Troy, MI (867 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

5.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Shaheen (43 Years) 43 Yrs

Troy Specialty Average (44.4 Years) 44.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	29	29	$240.00	$223.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	11	11	$125.00	$123.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	37	37	$240.00	$223.73
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	15	$125.00	$123.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	39	39	$240.00	$228.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	38	38	$240.00	$230.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	21	15	$125.00	$125.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	24	24	$240.00	$212.44
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$200.00	$168.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	30	30	$240.00	$207.38
99213 Established patient office or other outpatient visit, typically 15 minutes	25	11	$100.00	$72.06
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$200.00	$164.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	36	24	$91.39	$71.64
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$196.36	$161.94
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	20	20	$236.25	$204.34

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License MI 2086S0122X

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

2761424 (MI)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

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Updated Practice Location July 07, 2010

Registered at 2585 CROOKS RD, TROY, MI 480844702 (Tel: 2482831110)

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Updated Business Mailing Address July 07, 2010

Registered at 2585 CROOKS RD, TROY, MI 480844702 (Tel: 2482831110)

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Provider Name / Credentials Updated July 07, 2010

Recorded as KENNETH SHAHEEN, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 07, 2010

Specialist (License #2086S0122X in MI)

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NPI Profile Reactivated March 27, 2006

Record officially reactivated for active practice on March 27, 2006

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NPI Profile Deactivated March 21, 2006

Record deactivated on March 21, 2006

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Initial NPI Registration & Enumeration August 02, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114928199

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 02, 2005

Last Update: July 07, 2010

Deactivation Date: March 21, 2006

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

2585 Crooks Rd

Troy, MI 480844702

Phone: 2482831110

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.