LEONID MIRONOVICH SHAMBAN (D.O.) – Gastroenterology Physician, NPI 1225398431

LEONID MIRONOVICH SHAMBAN (D.O.) is a healthcare provider. based in Southfield, Michigan. specializing in GASTROENTEROLOGY, INTERNAL MEDICINE. They hold the professional credentials D.O.. They hold a License No. 5101019763 (MI). The NPI Number for LEONID MIRONOVICH SHAMBAN (D.O.) is 1225398431

Main info

Male
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
LEONID MIRONOVICH SHAMBAN (D.O.)
NPI
1225398431
Phone
(248) 849-3281
Address
22250 Providence Dr Ste 301A
Enumeration Date
22 May 2012
Last Update Date
22 September 2025

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
5864470700
Graduation Year
2012 (14 years ago)
PAC ID
7416258975
Group Practice PAC ID
3375525215
Professional Enrollment ID
I20160708002060
Address ID
MI480813017SA28963AVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:14State licenses:1Digital endpointsOther names

648 GASTROENTEROLOGY in MI

Provider Addresses for LEONID MIRONOVICH SHAMBAN (D.O.)

  • 22250 Providence Dr Ste 301A

    Southfield, MI 480756211

    Phone: (248) 849-3281

    Fax: (248) 849-5449

    Type: Location

  • 28963 LITTLE MACK AVE STE 101

    SAINT CLAIR SHORES, MI 480813017

    Phone: (586) 447-0700

    Fax: (586) 447-0795

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 297 Open Payments records for all available years, with a total value of $8,184.

Total Amount is formed as General ($8,184) + Research ($0) + Ownership ($0) = $8,184.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Janssen Scientific Affairs, LLC ($1,701).

Total Amount

$8,184

General + Research + Ownership

Payments

297

Total payment records

General Amount

$8,184

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-07-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160708002060IGastroenterologyMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
88305Pathology examination of tissue using a microscope, intermediate complexity396135$0
99213Established patient office or other outpatient visit, 20-29 minutes11284$0
45380Biopsy of large bowel using a flexible endoscope9898$0
45385Removal of polyps or growths of large bowel using an endoscope with mechanical snare9897$0
43239Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope8277$0
View full utilization report →

Insurance plans in this area (ZIP 48075)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3375525215View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YMI
Physician AssistantMI
Nurse PractitionerMI
Nurse PractitionerMI
G A S T R O E N T E R O L O G YMI
G A S T R O E N T E R O L O G YMI
G A S T R O E N T E R O L O G YMI
-MI
G A S T R O E N T E R O L O G YMI
G A S T R O E N T E R O L O G YMI

Reviews

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Frequently asked questions

What NPI should I save for LEONID MIRONOVICH SHAMBAN (D.O.)?
Save NPI 1225398431 if you need a stable reference for LEONID MIRONOVICH SHAMBAN (D.O.).
Is LEONID MIRONOVICH SHAMBAN (D.O.) active in the national directory?
LEONID MIRONOVICH SHAMBAN (D.O.)'s public NPI profile is in an active state.
What field does LEONID MIRONOVICH SHAMBAN (D.O.) work in?
You can think of LEONID MIRONOVICH SHAMBAN (D.O.) as practicing within Gastroenterology Physician. Clinical services aligned with this taxonomy classification.
Does LEONID MIRONOVICH SHAMBAN (D.O.) practice in Michigan?
You will see Southfield, Michigan on file for LEONID MIRONOVICH SHAMBAN (D.O.) alongside any extra practice locations.
Is LEONID MIRONOVICH SHAMBAN (D.O.) a real provider?
This page reflects official NPPES data for NPI 1225398431. Always confirm identity and privileges with the practice and licensing boards.

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