Shaik Ejazuddin, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME74544 Issued in FL

Practice address

1741 David Walker Dr
Tavares, FL 32778-5745

Phone

(352) 742-8836

NPI assigned

Oct 12, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

Internal MedicineAlso: Hospitalist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid Florida Hospital Specialists PAGroup PAC ID 5092628107, 53 clinicians

Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Inpatient Care Specialists LLCGroup PAC ID 0345493623, 101 clinicians

Central Florida Inpatient Medicine LLCGroup PAC ID 7911805254, 113 clinicians

Orlando Inpatient Medicine PAGroup PAC ID 0749598316, 54 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
• Select Specialty Hospital - the Villages Long-term care hospital, Oxford, FL, CCN 102028

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: sejazuddin111285@orlandohealth.medalliesdirect.net

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.

• Central Florida Inpatient Medicine LLC

  • Internal Medicine Physician
  • Lake Mary, FL
  • NPI 1649228859

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Mid Florida Hospital Specialists PA

  • Internal Medicine Physician
  • Winter Springs, FL
  • NPI 1588675912

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Orlando Inpatient Medicine, PA

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1902287899

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Florida Hospital Medical Group Inc

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234
  Medicare reassignment Care Compare group
• Advance Neuropathy Institute LLC

  • Internal Medicine Physician
  • Winter Park, FL
  • NPI 1063296929

  Multi-Specialty

  Medicare reassignment NPD
• American Neuropathy Institute LLC

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1528892049

  Multi-Specialty

  Medicare reassignment NPD
• Cogent Healthcare of Pensacola LLC

  • Internal Medicine Physician
  • Jacksonville Beach, FL
  • NPI 1346287182

  Multi-Specialty

  Medicare reassignment NPD
• Florida Med-Psych Consultants LLC

  • Hospitalist Physician
  • Orlando, FL
  • NPI 1063905925

  Multi-Specialty

  Medicare reassignment NPD
• Halifax Healthcare Systems Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530

  Multi-Specialty

  Medicare reassignment NPD
• Physicians of Central Florida, LLC

  • Internal Medicine Physician
  • Mount Dora, FL
  • NPI 1861421018

  Multi-Specialty

  Medicare reassignment NPD
• United Health Group and Associates LLC

  • Clinic/Center
  • Orlando, FL
  • NPI 1912560442

  Multi-Specialty

  Medicare reassignment NPD
• Psynergy Health Med PLLC

  • Primary Care Clinic/Center
  • Orlando, FL
  • NPI 1891513420
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health System-Sunbelt, Inc

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation
• Select Specialty Hospital - the Villages Inc

  • Long Term Care Hospital
  • Oxford, FL
  • NPI 1629532023

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1073501185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5728 MAJOR BLVD",
            "address_2": "STE 528",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197962",
            "telephone_number": "352-742-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 DAVID WALKER DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785745",
            "telephone_number": "352-742-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJAZUDDIN",
        "first_name": "SHAIK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME74544",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME74544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asim F Durrani, M.D.
• Ear, Nose & Throat Associates of Lake County , PA
• Walter Ray Earnest, DPM
• Allison Renee Echevarria, APRN
• Kristen M Edwards, PA-C
• Mary Theresa Elengical, D.O.
• Carine Elisma, FNP
• David J Ellingson, P.A.
• Ellis Integrative Family Practice Inc
• Gretta Ellis

• Internal Medicine Physician in Tavares, FL
• Providers in Tavares, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.