Individual provider Active NPI

Carl Tyler Shenkman, M.D., J.D., LLM

  • Neurology Physician
  • Clearwater, FL
National Provider Identifier
1083664874
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME118247 Issued in FL
Practice address
501 S Lincoln Ave Ste 22
Clearwater, FL 33756-5964
Phone
(727) 357-7828
Fax
(727) 337-7646
NPI assigned
May 11, 2006
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036000 GA
Neurology Physician 2084N0400X 36000 GA
Neurology Physician 2084N0400X ME118247 FL Primary
Hospitalist Physician 208M00000X ME118247 FL

Addresses

Primary practice location

501 S Lincoln Ave Ste 22
Clearwater, FL 33756-5964

Mailing address

501 S Lincoln Ave Ste 22
Clearwater, FL 33756-5964
Phone (727) 357-7828

Other identifiers 3

IdentifierTypeStateIssuer
011898500MedicaidFL
P00187661OtherGARAILROAD MEDICARE PIN
000516942HMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL, NY3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20040724000238 GA Practitioner - Neurology 8325028749 Reassigns benefits to 2 organizations
I20140728000815 FL Practitioner - Neurology 8325028749 Reassigns benefits to 2 organizations
I20250219000541 NY Practitioner - Neurology 8325028749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurology Medicine Services of FL LLCGroup PAC ID 0244605681, 6 clinicians
Kel Healthcare Medical Services PCGroup PAC ID 3971031089, 2 clinicians

Practice addresses (Care Compare)

201 14TH St SW
HCA Florida Largo Hospital
Largo, FL 33770-3133
Phone (727) 588-5200

6144 Route 25a
Suite 9
Wading River, NY 11792-2015
Phone (631) 910-4201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36000GAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seaside Wellness Primary Care PLLC CurrentSince May 7, 2024 Accepting new patients
Neuro-Stat Neurology CurrentSince Jan 1, 2017 Accepting new patients
Neurology Medicine Services of FL, LLC Neurology CurrentSince Apr 1, 2023 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2019 Accepting new patients
Lifeline Tests Incorporated CurrentSince Apr 25, 2025 Accepting new patients
Complete Brain Testing LLC CurrentSince Jul 1, 2025 Accepting new patients
Neurological Institute of Atlanta CurrentSince Jan 18, 2010 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Kel Healthcare Medical Services PC CurrentSince Jan 2, 2025 Accepting new patients
Pain and Accident Chiropractic-Roswell LLC PastSince Jul 4, 2021 Accepting new patients
Archbold Medical Group, Inc. Past Accepting new patients
Georgia Neurology and Rehab Specialist PastSince Oct 1, 2002 Accepting new patients

Locations

501 S Lincoln Ave
Ste 22
Clearwater, FL 33756
Phone (727) 357-7828

1000 Mar Walt Dr
#H
Fort Walton Beach, FL 32547

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

200 2nd Ave S
St Petersburg, FL 33701
Phone (727) 465-8515

8142 Bellarus Way
Ste 104
Trinity, FL 34655
Phone (727) 202-1303

1111 Glynco Pkwy
Ste 400
Brunswick, GA 31525
Phone (912) 262-1801

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

425 E Crossville Rd
Ste 101
Roswell, GA 30075
Phone (678) 214-8547

1530 Bedford Ave
Fl 3
Brooklyn, NY 11216
Phone (718) 400-6951

1866 Wading River Manor Rd
Wading River, NY 11792
Phone (631) 910-4200

6315 Roosevelt Ave
Woodside, NY 11377
Phone (718) 810-4717

Organizations & group practices 12

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1083664874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S LINCOLN AVE STE 22",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565964",
            "telephone_number": "727-357-7828",
            "fax_number": "727-337-7646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S LINCOLN AVE STE 22",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565964",
            "telephone_number": "727-357-7828",
            "fax_number": "727-337-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENKMAN",
        "first_name": "CARL",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "M.D., J.D., LLM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "036000",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "36000",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME118247",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME118247",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011898500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00187661",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000516942H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.