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DR. SHUMAIL MOHAMMAD RATHORE MD
NPI 1174215776
Family Medicine in Grand Blanc, MI

Active since May 22, 2023PECOS EnrolledAccepts Medicare Assignment
1 GENESYS PKWY, GRAND BLANC, MI 48439(631) 327-5094 Get Directions Write a Review

NPPES record last updated: June 26, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jun 26, 2025, Aug 23, 2023, May 22, 2023 (3 updates tracked since 2023).

About Dr. Shumail Mohammad Rathore Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHUMAIL MOHAMMAD RATHORE MD (NPI 1174215776) is an individual family medicine provider in Grand Blanc, Michigan, licensed in Michigan (4351051440) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1174215776
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SHUMAIL MOHAMMAD RATHORECredential: MD
Location Address1 GENESYS PKWYGrand Blanc, MI 48439-8065
Mailing Address1 Genesys PkwyGrand Blanc, MI 48439-8065 · (810) 606-5000
Phone(631) 327-5094
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 22, 2023
Last NPPES UpdateJune 26, 20253 updates tracked since enumeration
NPPES CertifiedJune 26, 2025
✔ NPI 1174215776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 4351051440
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 4301514401 (MI)
1 GENESYS PKWY, Grand Blanc, MI 48439
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Shumail Mohammad Rathore Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860975067
PECOS Enrollment IDI20260316003811
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Shumail Rathore reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Memorial Hospital
16 mi
General Practice
218 W MAIN ST STE 100
Flushing, MI 48433
  • Reassigned Medicare billing, Michigan enrollment
  • 328 clinicians in this Medicare group
NPI 1144428202 (989) 720-7562
Signify Health Medical Associates, PLLC
994 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Michigan enrollment
  • 666 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48439 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ILONA CROWDER COTA/L
Occupational Therapy Assistant
1 GENESYS PKWY
GRAND BLANC, MI 48439
Genesee County (877) 252-4469
DR. TARA STONE MD, MPH
Emergency Medicine
1 GENESYS PKWY
GRAND BLANC, MI 48439
Genesee County (810) 606-5000
ART OF RADIOLOGY IMAGING ASSOCIATES, PLLC
Radiology (Diagnostic Radiology)
1 GENESYS PKWY
GRAND BLANC, MI 48439
Genesee County (248) 308-2745
ERICA MA
Family Medicine
1 GENESYS PKWY
GRAND BLANC, MI 48439
Genesee County (810) 606-5000
YONG S CHUNG M.D.
Anesthesiology
1 GENESYS PKWY
GRAND BLANC, MI 48439
Genesee County (810) 606-6499
KARA KALINOWSKI
Nurse Anesthetist, Certified Registered
1 GENESYS PKWY
GRAND BLANC, MI 48439
Genesee County (810) 341-3971
MICHAEL BRIGGS DO
Emergency Medicine (Emergency Medical Services)
1 GENESYS PKWY
GRAND BLANC, MI 48439
Genesee County (810) 606-6137
JORDAN SPENCER MCCOY D.O.
Orthopaedic Surgery
1 GENESYS PKWY
GRAND BLANC, MI 48439
Genesee County (810) 606-7392

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shumail Rathore's NPI number?

The NPI number for Shumail Rathore is 1174215776. It was assigned to this individual provider in the NPPES registry on May 22, 2023.

Where is Shumail Rathore located?

Shumail Rathore practices at 1 Genesys Pkwy, Grand Blanc, MI 48439. The listed phone number is (631) 327-5094.

What is Shumail Rathore's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shumail Rathore enrolled in Medicare?

Yes. Shumail Rathore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Shumail Rathore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shumail Rathore reassigns Medicare benefits to 2 organizations: Memorial Hospital (Flushing, MI) and Signify Health Medical Associates, PLLC (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shumail Rathore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shumail Rathore accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Shumail Rathore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shumail Rathore was last updated on June 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.