NPIMap

Individual provider Active NPI

Shyam Kumar Rajendra Injety, MMS, PA-C

  • Medical Physician Assistant
  • Winter Haven, FL
National Provider Identifier
1063886984
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9108987 Issued in FL
Practice address
200 Avenue F NE
Winter Haven, FL 33881-4131
Phone
(863) 293-1121
NPI assigned
Nov 16, 2015
Last updated
May 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9108987 FL Primary

Addresses

Primary practice location

200 Avenue F NE
Winter Haven, FL 33881-4131

Mailing address

200 Avenue F NE
Winter Haven, FL 33881-4193
Phone (863) 293-1121

Other practice location 1

1 Va Ctr
Augusta, ME 04330-6719
Phone (207) 623-8411 ext. 5959

Other practice location 2

13800 Veterans Way
Orlando, FL 32827-7401
Phone (407) 631-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190722002212 FL Practitioner - Physician Assistant 1456650167 Reassigns benefits to 5 organizations
I20230203002360 TX Practitioner - Physician Assistant 1456650167 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.82
Promoting interoperability
91
Improvement activities
40
Cost
84.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9108987FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Jul 8, 2025 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Nov 7, 2022 Accepting new patients
US Health Dept of Health & Human Services CurrentSince Nov 14, 2024 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Jul 8, 2025 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Nov 14, 2024 Accepting new patients
Inphynet Contracting Services LLC Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1063886984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814193",
            "telephone_number": "863-293-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814131",
            "telephone_number": "863-293-1121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Va Ctr",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043306719",
            "country_code": "US",
            "telephone_number": "207-623-8411 x5959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13800 Veterans Way",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328277401",
            "country_code": "US",
            "telephone_number": "407-631-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INJETY",
        "first_name": "SHYAM KUMAR",
        "middle_name": "RAJENDRA",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-16",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.