Individual provider Active NPI

Hardik Shah, MD, MPH

  • Gastroenterology Physician
  • Port Orange, FL
National Provider Identifier
1043766702
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME163340 Issued in FL
Practice address
3635 Clyde Morris Blvd Ste 100
Port Orange, FL 32129-2349
Phone
(386) 788-1242
NPI assigned
Aug 31, 2016
Last updated
May 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME163340 FL Primary

Addresses

Primary practice location

3635 Clyde Morris Blvd Ste 100
Port Orange, FL 32129-2349

Mailing address

4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (904) 398-7205

Other practice location 1

305 Clyde Morris Blvd Ste 270
Ormond Beach, FL 32174-8182
Phone (386) 788-1242

Other names 1

  • Hardikkumar Mukeshbhai Shah Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230630002222 PA Practitioner - Gastroenterology 7214396738 Reassigns benefits to 1 organization
I20240604000103 FL Practitioner - Gastroenterology 7214396738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Borland Groover Clinic, PAGroup PAC ID 6507761301, 128 clinicians

Practice addresses (Care Compare)

3635 S Clyde Morris Blvd
Suite 100
Port Orange, FL 32129-2349
Phone (386) 788-1242

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
78.94 of 100Reported as group
Quality
69.69
Promoting interoperability
89
Improvement activities
40
Cost
69.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy130
Upper gastrointestinal (GI) endoscopy for acid reflux304

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic Current Accepting new patients
Allegheny Clinic CurrentSince Jul 1, 2023 Accepting new patients
Allegheny Clinic Gastroenterology CurrentSince Jul 1, 2023 Accepting new patients
Borland Groover Clinic, PA Gastroenterology CurrentSince Jul 20, 2024 Accepting new patients
Gastrointestinal Associates PA PastSince May 26, 2024 Accepting new patients

Locations

4800 Belfort Rd
Jacksonville, FL 32256
Phone (904) 307-2084

836 Prudential Dr
Ste 801
Jacksonville, FL 32207
Phone (904) 288-0433

305 Clyde Morris Blvd
Ste 270
Ormond Beach, FL 32174
Phone (386) 788-1242

3635 Clyde Morris Blvd
Ste 100
Port Orange, FL 32129
Phone (386) 788-1242

23 Mack Bayou Loop
Santa Rosa Beach, FL 32459
Phone (850) 390-4540

1307 Federal St
Ste B100
Pittsburgh, PA 15212
Phone (412) 359-4667

4 Allegheny Ctr
Fl 7
Pittsburgh, PA 15212

500 Blazier Dr
Ste 200
Wexford, PA 15090
Phone (412) 359-3319

Interoperability endpoints

  • Direct secure messaging: hardik.shah.p1@direct.bgclinic.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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 3

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": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1043766702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004",
            "telephone_number": "904-398-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 CLYDE MORRIS BLVD STE 100",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321292349",
            "telephone_number": "386-788-1242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Clyde Morris Blvd Ste 270",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321748182",
            "country_code": "US",
            "telephone_number": "386-788-1242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "HARDIK",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME163340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HARDIKKUMAR",
            "last_name": "SHAH",
            "middle_name": "MUKESHBHAI",
            "credential": "MD, MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

Verify at the official NPI Registry.