Individual provider Active NPI

Raj Subhash Shah, M.D.

  • Internal Medicine Physician
  • Miramar, FL
National Provider Identifier
1073995049
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME139688 Issued in FL
Practice address
3601 SW 160TH Ave Ste 250
Miramar, FL 33027-6314
Phone
(877) 866-7123
NPI assigned
Jun 25, 2015
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME139688 FL
Internal Medicine Physician 207R00000X ME139688 FL Primary

Addresses

Primary practice location

3601 SW 160TH Ave Ste 250
Miramar, FL 33027-6314

Mailing address

3601 SW 160TH Ave Ste 250
Miramar, FL 33027-6314
Phone (954) 213-6251

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200303001528 FL Practitioner - Internal MedicinePractitioner - Peripheral Vascular DiseasePractitioner - Family Practice 5395087811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Peripheral Vascular Disease
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

324 Wilder Blvd
Daytona Beach, FL 32114-6025
Phone (866) 877-7123

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue4605
Removal of skin lesions72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Post Acute Care Clinicians, LLC Family Medicine CurrentSince Feb 21, 2020 Accepting new patients
Florida Post Acute Care Clinicians, LLC Family Medicine CurrentSince Feb 21, 2020 Accepting new patients

Locations

324 Wilder Blvd
Daytona Beach, FL 32114
Phone (386) 252-2600

5888 Blanding Blvd
Jacksonville, FL 32244
Phone (904) 612-7385

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

1780 N Jefferson Hwy
Monticello, FL 32344
Phone (800) 708-4008

Organizations & group practices 2

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.

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1073995049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE STE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276314",
            "telephone_number": "954-213-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE STE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276314",
            "telephone_number": "877-866-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RAJ",
        "middle_name": "SUBHASH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME139688",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME139688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.