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SHALOM MEDICAL INC
NPI 1417318635
Internal Medicine - Infectious Disease in De Pere, WI

Active since March 15, 2016
977 GREEN RIDGE DR, DE PERE, WI 54115(718) 530-8357(920) 328-9050 Get Directions Write a Review

NPPES record last updated: March 15, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Shalom Medical Inc NPPES

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

SHALOM MEDICAL INC (NPI 1417318635) is a healthcare organization registered as an infectious disease in De Pere, Wisconsin and active in the NPI registry since March 2016. The organization lists Adetujni Adejumo, Owner, as its authorized official.

NPPES Registry Identity

NPI1417318635
Entity TypeOrganization
Primary Taxonomy207RI0200X
Legal Business NameSHALOM MEDICAL INC
Location Address977 GREEN RIDGE DRDe Pere, WI 54115-7656
Mailing Address977 Green Ridge DrDe Pere, WI 54115-7656
Phone(718) 530-8357
Fax(920) 328-9050
Organization SubpartNo
Authorized OfficialAdetujni AdejumoOwner · (718) 530-8357
Enumeration DateMarch 15, 2016
✔ NPI 1417318635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
977 GREEN RIDGE DR, De Pere, WI 54115
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Dean Health Plan.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)

Shalom Medical Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Shalom Medical Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Adetunji Adejumo, MD
Infectious Disease
NPI 1942532528
835 S VAN BUREN ST
Green Bay, WI 54301
(920) 496-4700
✔ PECOS✔ Accepts Medicare5.7 mi

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 Shalom Medical Inc's NPI number?

The NPI number for Shalom Medical Inc is 1417318635. It was assigned to this organization in the NPPES registry on March 15, 2016.

Where is Shalom Medical Inc located?

Shalom Medical Inc is located at 977 Green Ridge Dr, De Pere, WI 54115. The listed phone number is (718) 530-8357.

What is Shalom Medical Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Shalom Medical Inc enrolled in Medicare?

Yes. Shalom Medical Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Shalom Medical Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Infectious Disease) reassigns their Medicare billing to Shalom Medical Inc. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Shalom Medical Inc accept?

Health plans from Dean Health Plan list Shalom Medical Inc 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 Shalom Medical Inc was last updated on March 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.