NPIMap

Organization Active NPI

SMH Physician Services Inc

  • Internal Medicine Physician
  • Sarasota, FL
National Provider Identifier
1063403301
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SMH PHYSICIAN SERVICES INC
Practice address
1215 S East Ave
Suite 307
Sarasota, FL 34239-2342
Phone
(941) 366-9641
Fax
(941) 366-6305
NPI assigned
Nov 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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

Authorized official

Name
Ms. Della K. Shaw
Title
Coo
Phone
(941) 917-8720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X FL Primary

Addresses

Primary practice location

1215 S East Ave
Suite 307
Sarasota, FL 34239-2342

Mailing address

PO Box 863407
Orlando, FL 32886-3407
Phone (941) 366-9641

Other identifiers 1

IdentifierTypeStateIssuer
376537700MedicaidFL

Other names 1

  • Weiss & Bhamidipati -First Physicians Group of Sarasota Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031231000211 FL Part B Supplier - Clinic/Group Practice 1355240177 Receives reassigned benefits from 1,046 practitioners
42 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sarasota, FL; Venice, FL; Osprey, FL; Lakewood Ranch, FL; North Port, FL; Bradenton, FL; North Venice, FL

Other NPIs on the same Medicare enrollment 42

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 42

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1063403301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-366-9641",
            "fax_number": "941-366-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 S EAST AVE",
            "address_2": "SUITE 307",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392342",
            "telephone_number": "941-366-9641",
            "fax_number": "941-366-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMH PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "DELLA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "941-917-8720",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376537700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weiss & Bhamidipati -First Physicians Group of Sarasota",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.