NPIMap

Individual provider Active NPI

Shawn Wayne Thomas, D.O.

  • Urology Physician
  • Ormond Beach, FL
National Provider Identifier
1043416506
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
OS10348 Issued in FL
Practice address
300 Clyde Morris Blvd Ste C
Ormond Beach, FL 32174-5909
Phone
(386) 673-5100
Fax
(386) 673-6014
NPI assigned
Jun 22, 2007
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X OS10348 FL Primary
Urology Physician 208800000X 0S013305 PA
Urology Physician 208800000X 2603 WV

Addresses

Primary practice location

300 Clyde Morris Blvd Ste C
Ormond Beach, FL 32174-5909

Mailing address

300 Clyde Morris Blvd Ste C
Ormond Beach, FL 32174-5909
Phone (386) 673-5100

Other identifiers 2

IdentifierTypeStateIssuer
3810024050MedicaidWV
000282900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080826000136 FL Practitioner - Urology 8921173923 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Urology Center PAGroup PAC ID 8224927132, 11 clinicians

Practice addresses (Care Compare)

300 Clyde Morris Blvd
Suite C
Ormond Beach, FL 32174-5956
Phone (386) 673-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS10348FLMDUrology Physician
0S013305PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Sep 25, 2020 Accepting new patients
Cleveland Clinic Florida a Nonprofit Corporation CurrentSince Jul 1, 2008 Accepting new patients
Halifax Healthcare Systems Inc Urology CurrentSince Jan 6, 2014 Accepting new patients
Florida Urology Center PA Urology CurrentSince May 1, 2025 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Sep 25, 2020 Accepting new patients
Atlantic Urological Associates P a Urology PastSince May 1, 2025 Accepting new patients
Rockledge Hma Medical Group, LLC Past Accepting new patients
THS Physician Partners Inc Urology Past Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

311 N Clyde Morris Blvd
Ste 360
Daytona Beach, FL 32114
Phone (386) 254-4199

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

300 Clyde Morris Blvd
Ste C
Ormond Beach, FL 32174
Phone (386) 673-5100

790 Dunlawton Ave
Ste H
Pt Orange, FL 32127
Phone (386) 322-8880

2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 689-5000

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1043416506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CLYDE MORRIS BLVD STE C",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745909",
            "telephone_number": "386-673-5100",
            "fax_number": "386-673-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CLYDE MORRIS BLVD STE C",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745909",
            "telephone_number": "386-673-5100",
            "fax_number": "386-673-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SHAWN",
        "middle_name": "WAYNE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "OS10348",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "0S013305",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WV",
            "license": "2603",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810024050",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000282900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.