NPIMap

Individual provider Active NPI

Shawnette Simone Saddler, M.D.

  • Internal Medicine Physician
  • Coral Springs, FL
National Provider Identifier
1083858930
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME109668 Issued in FL
Practice address
9750 NW 33Rd St Ste 202
Coral Springs, FL 33065-4081
Phone
(954) 320-3390
Fax
(954) 340-4557
NPI assigned
Apr 22, 2009
Last updated
Mar 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME109668 FL Primary
Pediatrics Physician 208000000X ME109668 FL
Hospitalist Physician 208M00000X ME109668 FL

Addresses

Primary practice location

9750 NW 33Rd St Ste 202
Coral Springs, FL 33065-4081

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 320-3390

Other identifiers 1

IdentifierTypeStateIssuer
003801900MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110922000266 FL Practitioner - Internal MedicinePractitioner - Pediatric Medicine 7315118346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Tufts University School of Dental Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Broward Hospital DistrictGroup PAC ID 3577472422, 192 clinicians

Practice addresses (Care Compare)

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510

9750 NW 33Rd St
Coral Springs, FL 33065-4081

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Broward Hospital District CurrentSince Jul 1, 2011 Accepting new patients
North Broward Hospital District Current Accepting new patients
North Broward Hospital District Internal Medicine CurrentSince Jul 1, 2011 Accepting new patients
North Broward Hospital District Past Accepting new patients

Locations

9750 NW 33rd St
Ste 202
Coral Springs, FL 33065
Phone (954) 320-3390

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

1700 NW 49th St
Ste 125
Ft Lauderdale, FL 33309
Phone (954) 355-3490

6401 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 776-8500

Organizations & group practices 4

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 4

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": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1083858930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-320-3390",
            "fax_number": "954-340-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9750 NW 33RD ST STE 202",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654081",
            "telephone_number": "954-320-3390",
            "fax_number": "954-340-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADDLER",
        "first_name": "SHAWNETTE",
        "middle_name": "SIMONE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-22",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME109668",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME109668",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME109668",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003801900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.