LEONID MIRONOVICH SHAMBAN D.O.
NPI 1225398431
Internal Medicine - Gastroenterology in Saint Clair Shores, MI

Q: What is Leonid Shamban's NPI number?

The NPI number for Leonid Shamban is 1225398431. It was assigned to this individual provider in the NPPES registry on May 22, 2012.

Q: What is Leonid Shamban's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Leonid Shamban was last updated on September 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since May 22, 2012PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

28963 LITTLE MACK AVE STE 101, SAINT CLAIR SHORES, MI 48081(586) 447-0700(586) 498-0707 Get Directions Write a Review

NPPES record last updated: September 22, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 4, 2025, May 15, 2018, May 3, 2018 (3 updates tracked since 2018).

On this page

About Leonid Mironovich Shamban D.o. NPPES

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

LEONID MIRONOVICH SHAMBAN D.O. (NPI 1225398431) is an individual gastroenterology provider in Saint Clair Shores, Michigan, licensed in Michigan (5101019763) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence Hospital, Southfield And Novi, and maintains a secondary practice location in Southfield.

NPPES Registry Identity

NPI1225398431

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameLEONID MIRONOVICH SHAMBANCredential: D.O.

Location Address28963 LITTLE MACK AVE STE 101Saint Clair Shores, MI 48081-3017

Mailing Address28963 Little Mack Ave Ste 101Saint Clair Shores, MI 48081-3017 · (586) 447-0700 · Fax (586) 447-0795

Phone(586) 447-0700

Fax(586) 498-0707

Sole ProprietorYes

Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 2012

Enumeration DateMay 22, 2012

Last NPPES UpdateSeptember 22, 20253 updates tracked since enumeration

NPPES CertifiedSeptember 22, 2025

✔ NPI 1225398431 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in MI · 5101019763

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

28963 LITTLE MACK AVE STE 101, Saint Clair Shores, MI 48081

Open in Google Maps ↗

Secondary Practice Location 1

Location 122250 Providence Dr Ste 301ASouthfield, MI 48075-6211 · Phone (248) 849-3281 · Fax (248) 849-5449

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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

Leonid Mironovich Shamban D.o. 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 ID7416258975

PECOS Enrollment IDI20160708002060

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

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

Gi Medical Assoc PC

Same address

Gastroenterology

28963 LITTLE MACK AVE, SUITE 101
Saint Clair Shores, MI 48081

Reassigned Medicare billing, Michigan enrollment
9 clinicians in this Medicare group

NPI 1154311405 (586) 447-0700

Ascension Providence Hospital

17 mi

Psychiatry

16001 W 9 MILE RD, PHYSICIAN BILLING SERVICES
Southfield, MI 48075

Reassigned Medicare billing, Michigan enrollment
Medicare enrollment name: Henry Ford Health Providence Hospital
393 clinicians in this Medicare group

NPI 1619932670 (248) 849-3000

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

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, vedolizumab, intravenous, 1 mg J3380

Vedolizumab is a medication given via injection. It's used to treat certain bowel conditions (such as Crohn's disease, ulcerative colitis) by reducing inflammation. It works by blocking a certain protein that causes this inflammation.

7,200 services11 patients

Pathology examination of tissue using a microscope, intermediate complexity 88305

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

434 services150 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

114 services92 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

99 services98 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

96 services96 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

90 services56 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

81 services77 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

77 services64 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

38 services37 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

27 services12 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

22 services22 patients

Imaging of digestive tract done from the inside of the digestive tract 91110

This procedure, known as an endoscopy, involves a small camera being passed into the digestive tract. It helps doctors to see the inside of your digestive system in detail. This can aid in diagnosing conditions or planning treatments. It's generally safe and can provide valuable information.

15 services15 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

14 services14 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension Providence Hospital, Southfield And Novi

Acute Care Hospitals · Southfield, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230019

Location16001 W Nine Mile RdSouthfield, MI 48075 · Oakland County

Emergency services Birthing friendly

Henry Ford Health Hospital

Acute Care Hospitals · Detroit, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230053

Location2799 W Grand BlvdDetroit, MI 48202 · Wayne County

Emergency services Birthing friendly

Beaumont Hospital - Grosse Pointe

Acute Care Hospitals · Grosse Pointe, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230089

Location468 Cadieux RdGrosse Pointe, MI 48230 · Wayne County

Emergency services Birthing friendly

Ascension St John Hospital

Acute Care Hospitals · Detroit, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230165

Location22101 Moross RdDetroit, MI 48236 · Wayne County

Emergency services Birthing friendly

Ascension Macomb Oakland Hosp-Warren Campus

Acute Care Hospitals · Warren, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230195

Location11800 East Twelve Mile RoadWarren, MI 48093 · Macomb County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48081 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

$134.28 typical visit price

range $58.04 – $177.36

Typical copayment $33.57 (range $14.51 – $44.34)

Most-billed visit code 99204

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Other Providers at the Same Location NPPES 7

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

MS. SHAWNDELIN MARIE BRUNSMAN P.A.-C

Physician Assistant