RADIYA AFNAN SHABAZZ – Speech-Language Pathologist, NPI 1225875156

RADIYA AFNAN SHABAZZ is a healthcare provider. based in Kansas city, Missouri. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold a License No. 2024027036 (MO). The NPI Number for RADIYA AFNAN SHABAZZ is 1225875156

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
RADIYA AFNAN SHABAZZ
NPI
1225875156
Phone
(216) 973-2553
Address
3907 CAMPBELL ST
Enumeration Date
9 July 2024
Last Update Date
9 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8162491650
Graduation Year
2024 (2 years ago)
PAC ID
6103361837
Group Practice PAC ID
9638086432
Professional Enrollment ID
I20240717002173
Address ID
MO641191858GL2900XPKWY400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

192 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in MO

Provider Addresses for RADIYA AFNAN SHABAZZ

  • 3907 CAMPBELL ST

    KANSAS CITY, MO 641101111

    Phone: (216) 973-2553

    Type: Mailing

  • 8559 N LINE CREEK PKWY

    KANSAS CITY, MO 641542100

    Phone: (816) 468-8282

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-07-17

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
I20240717002173IQualified Speech Language PathologistMOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 64110)

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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: 9638086432View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeKS
Qualified Speech Language PathologistKS
-KS
Physical Therapist In Private PracticeMO
-TN
Physical Therapist In Private PracticeNE
Physical Therapist In Private PracticeNE
-KS
Physical Therapist In Private PracticeNE
Qualified Speech Language PathologistAR

Reviews

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Frequently asked questions

What unique ID ties claims to RADIYA AFNAN SHABAZZ?
NPI 1225875156 is assigned to RADIYA AFNAN SHABAZZ under the national enumeration system.
Is RADIYA AFNAN SHABAZZ's NPI currently valid?
The extract we use shows RADIYA AFNAN SHABAZZ as active.
What kind of provider is RADIYA AFNAN SHABAZZ?
The page reflects Speech-Language Pathologist for RADIYA AFNAN SHABAZZ. Clinical services aligned with this taxonomy classification.
What location shows for RADIYA AFNAN SHABAZZ?
We surface Kansas City, Missouri for RADIYA AFNAN SHABAZZ based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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