Active NPI
Prashanth Shanmugham, M.D.
- Pediatric Critical Care Medicine Physician
- Pensacola, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- ME145475
- Practice address
- 5151 N 9TH Ave
Pensacola, FL 32504-8721 - Phone
- (850) 416-4970
- NPI assigned
- Apr 15, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | ME145475 | FL | Primary |
Addresses
Primary practice location
5151 N 9TH Ave
Pensacola, FL 32504-8721
Mailing address
4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118231800 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pshanmugham344173@MHSDIRECT.NET |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sacred Heart Health System, Inc. | Current | Accepting new patients | |
| Pediatric Critical Care of S FL PA | Pediatric Critical Care Medicine | Current | Accepting new patients |
| Sacred Heart Health System Inc | Current | Accepting new patients | |
| Sacred Heart Health System, Inc. | Current | Accepting new patients |
Locations
1117 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (954) 454-5131
1005 N 35th Ave
Hollywood, FL 33021
Phone (954) 265-5324
4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691
3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000
1657 Trinity Dr
Pensacola, FL 32504
Phone (850) 416-2400
5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700
Interoperability endpoints
- pshanmugham344173@mhsdirect.net
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Critical Care Medicine Physician
- Hollywood, FL
- NPI 1164484432
-
- Family Medicine Physician
- Pensacola, FL
- NPI 1144271586
-
- Community/Retail Pharmacy
- Pensacola, FL
- NPI 1366260739
-
- Primary Care Clinic/Center
- Pensacola, FL
- NPI 1043261498
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728000000000",
"number": "1003340142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4205 BELFORT RD STE 4015",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322163623",
"telephone_number": "904-450-6063",
"fax_number": "904-539-4091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5151 N 9TH AVE",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325048721",
"telephone_number": "850-416-4970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANMUGHAM",
"first_name": "PRASHANTH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-15",
"last_updated": "2024-10-04",
"certification_date": "2024-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "FL",
"license": "ME145475",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "118231800",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pshanmugham344173@MHSDIRECT.NET",
"affiliation": "N",
"address_1": "1005 N 35th Ave",
"city": "Hollywood",
"state": "FL",
"country_code": "US",
"postal_code": "330215402",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.