Shishir David

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME163941 Issued in FL

Practice address

3059 Edgewood Ave W
Jacksonville, FL 32209-2207

Phone

(904) 647-3180

Fax

(904) 425-9030

NPI assigned

Jun 18, 2020

Last updated

Jul 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dedicated Senior Medical Center of Florida, LLCGroup PAC ID 4486932100, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: sdavid659940@direct.hfhs.org

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.

• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1881055366
  Medicare reassignment Care Compare group NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Tampa, FL
  • NPI 1700393881
  NPD

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1053937763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3059 EDGEWOOD AVE W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322092207",
            "telephone_number": "904-647-3180",
            "fax_number": "904-425-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3059 EDGEWOOD AVE W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322092207",
            "telephone_number": "904-647-3180",
            "fax_number": "904-425-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "SHISHIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-18",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME163941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David K. Rouse, D.C., P.a.
• David K. Sullivan, DMD, PA
• David Leonard Sall, M.D. P.a.
• Justin Mackenzie David
• Michael David
• Frances Nicole Davidson-Harshaw, LMHC
• Christina Davidson
• Danielle Blanchard Davidson, APRN
• Jabari Davidson, ARNP
• Mary Parker Davidson, FNP-C

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.