FYSAL SHENNIB (MD) – Anatomic Pathology & Clinical Pathology Physician, NPI 1275158628
Anatomic Pathology & Clinical Pathology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
120 PATHOLOGY in OK
Provider Addresses for FYSAL SHENNIB (MD)
4142 S MINGO RD
TULSA, OK 741463632
Phone: (918) 417-6400
Type: Mailing
2800 Plymouth Rd # 35-1411
Ann Arbor, MI 481092800
Phone: (734) 764-3270
Type: Location
1500 E Medical Center Dr
Ann Arbor, MI 481095000
Phone: (734) 936-4000
Type: Location
2800 PLYMOUTH RD # 35-1411
ANN ARBOR, MI 481092800
Phone: (734) 764-3270
Type: Mailing
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: 2026-02-19
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240827003989 | I | Pathology | MI | TBD |
| I20260219001549 | I | Pathology | OK | TBD |
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.
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 74146)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OK | |
| P A T H O L O G Y | OK | |
| P A T H O L O G Y | OK | |
| P A T H O L O G Y | OK | |
| P A T H O L O G Y | OK | |
| P A T H O L O G Y | OK | |
| P A T H O L O G Y | KS | |
| P A T H O L O G Y | TX | |
| P A T H O L O G Y | OK | |
| P A T H O L O G Y | OK |
Reviews
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