DR. THEODORE WILLIAM SHIVELY D.O.
NPI 1780666461
Family Medicine in Novi, MI

Q: What is Theodore Shively's NPI number?

The NPI number for Theodore Shively is 1780666461. It was assigned to this individual provider in the NPPES registry on November 17, 2005.

Q: What is Theodore Shively's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Theodore Shively was last updated on December 13, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since November 17, 2005PECOS EnrolledAccepts Medicare Assignment

39555 W 10 MILE RD, SUITE 302, NOVI, MI 48375(248) 426-7200 Get Directions Write a Review

NPPES record last updated: December 13, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Theodore William Shively D.o. NPPES

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

DR. THEODORE WILLIAM SHIVELY D.O. (NPI 1780666461) is an individual family medicine provider in Novi, Michigan, licensed in Michigan (5101007588) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence Hospital, Southfield And Novi, and is a graduate of Philadelphia College Of Osteopathic Medicine (1978).

NPPES Registry Identity

NPI1780666461

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. THEODORE WILLIAM SHIVELYCredential: D.O.

Location Address39555 W 10 MILE RD, SUITE 302Novi, MI 48375-2950

Mailing Address39555 W 10 Mile Rd, Suite 302Novi, MI 48375-2950 · (248) 426-7200

Phone(248) 426-7200

Sole ProprietorNo

Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 1978

Enumeration DateNovember 17, 2005

Last NPPES UpdateDecember 13, 2011

✔ NPI 1780666461 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 · 5101007588

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 ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X · License 5101007588 (MI)

39555 W 10 MILE RD, Novi, MI 48375

Open in Google Maps ↗

Other Identifiers 3

Medicare UPINC30350

Medicaid4233780MI

Medicare PIN0N141770001MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority 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. Theodore William Shively 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 ID2769376383

PECOS Enrollment IDI20040217000153

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 Theodore Shively reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Primecare Urgent Care PLLC

1.2 mi

Urgent Care

39555 W 10 MILE RD, SUITE 301
Novi, MI 48375

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

NPI 1174875140 (248) 426-7200

Primecare Of Novi PLLC

1.5 mi

Family Medicine

39555 WEST TEN MILE RD, SUITE 302
Novi, MI 48375

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

NPI 1235281916 (248) 426-7200

Primecare On Wixom PLLC

5.2 mi

Family Medicine

27250 WIXOM RD STE A
Novi, MI 48374

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

NPI 1982103362 (248) 426-7200

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 15

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.

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.

213 services110 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.

139 services96 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

126 services111 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

93 services85 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

82 services82 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

65 services65 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

22 services18 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

21 services20 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

21 services20 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

20 services20 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

19 services19 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

19 services19 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

17 services17 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

15 services15 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

12 services12 patients

Hospital Affiliations CMS Care Compare

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48375 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers14 claims34 services$5.11 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

3 suppliers24 claims32 services$185.10 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 8

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

CARLA ISMAIL

Dentist

39555 W 10 MILE RD
NOVI, MI 48375

Oakland County (248) 442-7305

DR. MICHAEL PATRICK BURK D.P.M.

Podiatrist

39555 W 10 MILE RD, SUITE 307
NOVI, MI 48375

Oakland County (248) 476-1500

KELLY M KRUEGER DO PLLC

Family Medicine

39555 W 10 MILE RD, SUITE 305
NOVI, MI 48375

Oakland County (248) 426-7200

PRIMECARE URGENT CARE PLLC

Clinic/Center (Urgent Care)

39555 W 10 MILE RD, SUITE 301
NOVI, MI 48375

Oakland County (248) 426-7200

LAUREN M DUNN

Nurse Practitioner (Family)

39555 W 10 MILE RD
NOVI, MI 48375

Oakland County (248) 426-9680

LISA MAROUN R.D.

Dietitian, Registered

39555 W 10 MILE RD, SUITE 302
NOVI, MI 48375

Oakland County (248) 426-7200

RICHARD M NEWMAN D.C. P.C.

Chiropractor

39555 W 10 MILE RD, #307
NOVI, MI 48375

Oakland County (248) 477-1240

MICHAEL P. BURK, D.P.M., PLLC

Podiatrist

39555 W 10 MILE RD, SUITE 307
NOVI, MI 48375

Oakland County (248) 476-1500

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 Theodore Shively's NPI number?

The NPI number for Theodore Shively is 1780666461. It was assigned to this individual provider in the NPPES registry on November 17, 2005.

Where is Theodore Shively located?

Theodore Shively practices at 39555 W 10 Mile Rd Suite 302, Novi, MI 48375. The listed phone number is (248) 426-7200.

What is Theodore Shively's specialty?

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

Is Theodore Shively enrolled in Medicare?

Yes. Theodore Shively 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 Theodore Shively's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theodore Shively reassigns Medicare benefits to 3 organizations: Primecare Urgent Care PLLC (Novi, MI), Primecare Of Novi PLLC (Novi, MI) and Primecare On Wixom PLLC (Novi, MI). 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 Theodore Shively's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Theodore Shively accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Theodore Shively 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.

Is Theodore Shively affiliated with any hospitals?

According to CMS data, Theodore Shively is affiliated with Ascension Providence Hospital, Southfield And Novi.

When was this NPI record last updated?

The NPPES record for Theodore Shively was last updated on December 13, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.