MINDSHAPE CLINIC
NPI 1174303077
Internal Medicine in Troy, MI
About Mindshape Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MINDSHAPE CLINIC (NPI 1174303077) is a healthcare organization registered as an internal medicine in Troy, Michigan and active in the NPI registry since September 2023. The organization maintains 2 additional practice locations and lists Hassan Khan, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Locations 2
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mindshape Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Mindshape Clinic, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Mindshape Clinic Plc's NPI number?
The NPI number for Mindshape Clinic Plc is 1174303077. It was assigned to this organization in the NPPES registry on September 29, 2023. The provider is also known as Mindshape Clinic.
Where is Mindshape Clinic Plc located?
Mindshape Clinic Plc is located at 2560 Lynwood Dr Ste 3, Troy, MI 48083. The listed phone number is (515) 650-3031.
What is Mindshape Clinic Plc's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Mindshape Clinic Plc enrolled in Medicare?
Yes. Mindshape Clinic Plc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mindshape Clinic Plc?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Mindshape Clinic Plc, in Hospitalist, Internal Medicine and Nurse Practitioner. A 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 the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Mindshape Clinic Plc accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of NC and Blue Cross and Blue Shield of Texas list Mindshape Clinic Plc 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 Mindshape Clinic Plc was last updated on December 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.
# Mindshape Clinic · NPI 1174303077
Internal Medicine organization in Troy, Michigan. Organization record, active in the CMS NPPES registry since September 29, 2023.
## Identity
- **NPI:** 1174303077 (Entity type: Organization)
- **Enumerated:** September 29, 2023
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Legal business name:** Mindshape Clinic Plc
- **Organization subpart:** No
- **Authorized official:** Hassan Khan, MEDICAL DIRECTOR
## Practice location
- **Address:** 2560 LYNWOOD DR STE 3, Troy, MI 48083-5681
- **Phone:** (515) 650-3031
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Hospitalist (1), Internal Medicine (1), Nurse Practitioner (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 9, 2024
- **Other identifiers:** Medicaid 00427241 (NC); Medicaid 7100785550 (KY)
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Source: [NPI Profile](https://npiprofile.com/npi/1174303077) · Data from the CMS NPPES public registry.