Individual provider Active NPI

MD Shahrier Amin, MBBS, PHD

  • Clinical Pathology/Laboratory Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1063821940
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
ME169353 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Aug 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X E-1000 AR
Anatomic Pathology Physician 207ZP0101X 27989 WV
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X ME169353 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Other practice location 1

1 Medical Center Dr
Morgantown, WV 26506-1200
Phone (304) 293-1608

Other practice location 2

800 Wheeling Ave
Glen Dale, WV 26038-1660
Phone (304) 845-3211

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mamin145789@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address mamin2277738@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, 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
I20190903003029 WV Practitioner - Pathology 4587884226 Reassigns benefits to 2 organizations
I20240919003312 FL Practitioner - Pathology 4587884226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

  • Mayo Clinic Hospital, Jacksonville, FL, CCN 100151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-1000ARMDAnatomic Pathology Physician
27989WVMDAnatomic Pathology Physician
ME169353FLMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Davis Memorial Hospital CurrentSince Aug 29, 2020 Accepting new patients
Wetzel County Hospital, Inc. CurrentSince Jul 1, 2020 Accepting new patients
West Virginia University Medical Corporation CurrentSince Sep 10, 2019 Accepting new patients
Davis Memorial Hospital CurrentSince Aug 29, 2020 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Aug 15, 2024 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Aug 15, 2024 Accepting new patients
West Virginia University Medical Corporation Family Medicine CurrentSince Sep 10, 2019 Accepting new patients
Wetzel County Hospital, Inc. Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Nephropathology Associates, PLC Anatomic Pathology Past Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

812 Gorman Ave
Elkins, WV 26241
Phone (304) 636-3300

800 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 221-4520

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

3 E Benjamin Dr
North Martinsvlle, WV 26155
Phone (304) 455-8000

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1063821940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265061200",
            "country_code": "US",
            "telephone_number": "304-293-1608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Wheeling Ave",
            "address_purpose": "LOCATION",
            "city": "Glen Dale",
            "state": "WV",
            "postal_code": "260381660",
            "country_code": "US",
            "telephone_number": "304-845-3211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMIN",
        "first_name": "MD SHAHRIER",
        "name_prefix": "Dr.",
        "credential": "MBBS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-05",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "AR",
            "license": "E-1000",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "WV",
            "license": "27989",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "FL",
            "license": "ME169353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mamin145789@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mamin2277738@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.