DR. SALIM M SHAMMO M.D.
NPI 1295791937
Internal Medicine - Cardiovascular Disease in Oak Creek, WI

NPI Status: Active since April 21, 2006

Contact Information

7901 S 6TH ST
OAK CREEK, WI
ZIP 53154
Phone: (414) 346-8000
Fax: (414) 346-8010

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 44
Internal Medicine
Cardiovascular Disease
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About SALIM SHAMMO

This page provides the complete NPI Profile along with additional information for Salim Shammo, an internist established in Oak Creek, Wisconsin with a medical specialization in Internal Medicine, focusing in cardiovascular disease and more than 44 years of experience. The healthcare provider is registered in the NPI registry with number 1295791937 assigned on April 2006. The practitioner's primary taxonomy code is 207RC0000X with license number 36011 (WI). The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI: 1295791937
Provider Name: DR. SALIM M SHAMMO M.D.
Gender: Male
Entity Type: Individual
Location Address: 7901 S 6TH ST OAK CREEK, WI 53154
Location Phone: (414) 346-8000
Location Fax: (414) 346-8010
Mailing Address: 7901 S 6TH ST OAK CREEK, WI 53154
Mailing Phone: (414) 346-8000
Mailing Fax: (414) 346-8010
Medical School Name: OTHER
Graduation Year: 1982
Is Sole Proprietor?: Yes
Enumeration Date: 04-21-2006
Last Update Date: 12-23-2019
Code Navigator

An internist like Salim Shammo is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Internal Medicine Cardiovascular Disease
Taxonomy Code: 207RC0000X
Type: Allopathic & Osteopathic Physicians
License No.: 36011
License State: WI
Taxonomy Description: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Anthem Blue Cross and Blue Shield

Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS

CareSource (Common Ground Healthcare)

CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
CareSource (Common Ground Healthcare) Gold $3300 - EPO
CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO

Group Health Cooperative-SCW

Partners HMO Bronze 10600 Ded/10600 MOOP HSA - HMO
Partners HMO Bronze 6000 Ded/10600 MOOP HSA - HMO
Partners HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
Partners HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
Partners HMO Gold 2000 Ded/8200 MOOP - HMO
Partners HMO Gold 4000 Ded/4000 MOOP HSA - HMO
Partners HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
Partners HMO Silver 5975 Ded/5975 MOOP HSA - HMO
Partners HMO Silver 6000 Ded/8900 MOOP - HMO

MercyCare Health Plans

MercyCare Bronze 10,000 (1 Free PCP Visit) - HMO
MercyCare Bronze Standard Expanded - HMO
MercyCare Gold Standard - HMO
MercyCare Silver 2,500 (3 Free PCP Visits) - HMO
MercyCare Silver Health Savings - HMO
MercyCare Silver Standard - HMO

Network Health

Prestige Bronze $0 Medical Deductible - HMO
Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
Prestige Bronze Essential + 3 Free PCP Visits - HMO
Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
Prestige Bronze Plus - HMO
Prestige Gold - HMO
Prestige Gold 50 + 1 Free PCP Visit - HMO
Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO

Quartz

QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO

Security Health Plan

Enrich $2,000 - 25% - HMO
Enrich $3,500 - 30% - HMO
Enrich $4,000 - 50% - HMO
Enrich $5,000 HDHP - HMO
Enrich $6,000 - 40% - HMO
Enrich $7,500 - HMO
Enrich $7,500 HDHP - HMO
Enrich $9,500 - HMO
Enrich Protection - HMO
Premier $2,000 - 25% - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
32078400	MEDICAID (05)	WI

Medicare Participation & PECOS Enrollment Status

Salim Shammo is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Salim Shammo is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 345236832
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20040421000824
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring, transmission and review and report by health care professional
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Evaluation of single, dual, multiple lead or leadless pacemaker system
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days
Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician
Heart rhythm review and interpretation of continous external ekg over 8-15 days
Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days
Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 45-59 minutes
Nuclear medicine studies of heart muscle at rest and with stress and spect
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $30.92 for a new patient copayment and $16.84 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 53154 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $123.69
Minimum New Patient Price $53.9
Maximum New Patient Price $163.24

Average New Patient Copayment $30.92
Minimum New Patient Copayment $13.47
Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $67.37
Minimum Established Patient Price $17.4
Maximum Established Patient Price $133.76

Average Established Patient Copayment $16.84
Minimum Established Patient Copayment $4.35
Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Chronic Care and Preventative Care Management for Empaneled Patients	Yes	N/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Documentation of Current Medications in the Medical Record	100%	1091
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Engagement of patients through implementation of improvements in patient portal	Yes	N/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
e-Prescribing	99%	2135
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Implementation of improvements that contribute to more timely communication of test results	Yes	N/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet	34%	823
Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active diagnosis of ischemic vascular disease (IVD) during the measurement period, and who had documentation of use of aspirin or another antiplatelet during the measurement period
Medication Reconciliation	100%	1679
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	100%	1091
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	16%	1090
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Provide Patient Access	49%	1091
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	0%	1091
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Salim Shammo is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type
OCONOMOWOC MEMORIAL HOSPITAL	791 E SUMMIT AVE OCONOMOWOC, WI 53066	(262) 569-9400	Acute Care Hospitals
FORT MEMORIAL HOSPITAL	611 SHERMAN AVE E FORT ATKINSON, WI 53538	(920) 568-5000	Acute Care Hospitals
UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY	600 HIGHLAND AVENUE MADISON, WI 53792	(608) 263-6400	Acute Care Hospitals
WATERTOWN MEMORIAL HOSPITAL	125 HOSPITAL DRIVE WATERTOWN, WI 53098	(920) 261-4210	Acute Care Hospitals
FROEDTERT MEMORIAL LUTHERAN HOSPITAL	9200 W WISCONSIN AVE MILWAUKEE, WI 53226	(414) 805-3000	Acute Care Hospitals

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1295791937, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 14 → 1 + 4

Pos 6

Unchanged

Pos 7

Doubled → 2

Pos 8

Unchanged

Pos 9

Doubled → 6

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 7 → 14 → 5 1 → 2 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 8 + 5 + 1 + 4 + 9 + 2 + 9 + 6 + 24 = 73

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 73 is 80. The difference is the calculated check digit.

80 - 73 = 7

This NPI is valid

The calculated check digit is 7, which matches the last digit of 1295791937.