Dr Theodore William Shively, DO - Medicare Family Practice in Novi, MI

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Dr Theodore William Shively, DO is a medicare enrolled "Family Medicine" physician in Novi, Michigan. He went to Philadelphia College Of Osteopathic Medicine and graduated in 1978 and has 46 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Primecare Of Novi Pllc, Primecare Urgent Care Pllc and his current practice location is 39555 W 10 Mile Rd, Suite 302, Novi, Michigan. You can reach out to his office (for appointments etc.) via phone at (248) 426-7200.

Dr Theodore William Shively is licensed to practice in Michigan (license number 5101007588) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1780666461.

Contact Information

Dr Theodore William Shively, DO
39555 W 10 Mile Rd, Suite 302,
Novi, MI 48375-2950
(248) 426-7200
Not Available

Map and Direction




Physician's Profile

Full NameDr Theodore William Shively
GenderMale
SpecialityFamily Practice
Experience46 Years
Location39555 W 10 Mile Rd, Novi, Michigan
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Theodore William Shively attended and graduated from Philadelphia College Of Osteopathic Medicine in 1978
  NPI Data:
  • NPI Number: 1780666461
  • Provider Enumeration Date: 11/17/2005
  • Last Update Date: 12/13/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 2769376383
  • Enrollment ID: I20040217000153

Medical Identifiers

Medical identifiers for Dr Theodore William Shively such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1780666461NPI-NPPES
4233780MedicaidMI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 5101007588 (Michigan)Primary
207QG0300XFamily Medicine - Geriatric Medicine 5101007588 (Michigan)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Ascension Providence Hospital, Southfield And NoviSouthfield, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Primecare Of Novi Pllc22643268837
Primecare Urgent Care Pllc77191154765

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Theodore William Shively allows following entities to bill medicare on his behalf.
Entity NamePrimecare Of Novi Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235281916
PECOS PAC ID: 2264326883
Enrollment ID: O20040212000644
Entity NamePrimecare Urgent Care Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174875140
PECOS PAC ID: 7719115476
Enrollment ID: O20140102001343
Entity NamePrimecare On Wixom Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982103362
PECOS PAC ID: 9032466537
Enrollment ID: O20180714000082

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Theodore William Shively is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Theodore William Shively, DO
39555 W 10 Mile Rd, Suite 302,
Novi, MI 48375-2950

Ph: (248) 426-7200		Dr Theodore William Shively, DO
39555 W 10 Mile Rd, Suite 302,
Novi, MI 48375-2950

Ph: (248) 426-7200

Reviews and Comments


Family Medicine Doctors in Novi, MI

Robert A Carter, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 26850 Providence Pkwy, Suite 375, Novi, MI 48374
Phone: 248-662-4200    Fax: 248-662-0368
Victoria Nicole Dooley, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 21580 Novi Rd, Ste 200, Novi, MI 48375
Phone: 248-946-4905    
Thomas Joseph Anan, MD
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 25691 Strath Haven Dr, Novi, MI 48374
Phone: 586-256-4170    Fax: 248-465-4901
Michael Balon, M.D.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 26850 Providence Pkwy, Suite 370, Novi, MI 48374
Phone: 248-465-4160    Fax: 248-465-4525
Moneer Al-nabolsi,
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 44130 W 12 Mile Rd, Novi, MI 48377
Phone: 248-380-8811    
Dr. Jeffrey Joshowitz, D.O.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 39475 Lewis Dr, Suite 140, Novi, MI 48377
Phone: 248-489-0766    Fax: 248-489-0788
Dr. Bilal Tarek Malek, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 39555 Orchard Hill Pl Ste 600, Novi, MI 48375
Phone: 248-621-4581    Fax: 248-621-4582

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.