Individual provider Active NPI

Shakib Shokry Sakla Namas, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Clearwater, FL
National Provider Identifier
1093780926
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
036087200 Issued in IL
Practice address
17757 US Highway 19 N Ste 175
Clearwater, FL 33764-6564
Phone
(727) 270-9800
NPI assigned
Feb 22, 2006
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X ME47201 FL
Spinal Cord Injury Medicine Physician 2081P0004X 036087200 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036087200 IL Primary

Addresses

Primary practice location

17757 US Highway 19 N Ste 175
Clearwater, FL 33764-6564

Mailing address

6400 Shafer CT Ste 700
Rosemont, IL 60018-4989
Phone (346) 376-1702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040827000275 IL Practitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Physical Medicine and RehabilitationPractitioner - Geriatric Medicine 4082689658 Reassigns benefits to 1 organization
Practice locations: Northlake, IL; Hinsdale, IL; Chicago, IL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME47201FLMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rajiv Kandala M D S C CurrentSince Nov 1, 2004 Accepting new patients
Physicians Medical Services, LTD. CurrentSince Sep 22, 2017 Accepting new patients
Seasons Hospice & Palliative Care of Pasco County, LLC Hospice and Palliative Medicine CurrentSince Oct 10, 2022 Accepting new patients
Southside Primary Care Group SC PastSince Feb 11, 2024 Accepting new patients
Associates in Pulmonary & Critical Care LTD Past Accepting new patients
Seasons Hospice & Palliative Care of Tampa, LLC Hospice and Palliative Medicine Past Accepting new patients
Seasons Hospice & Palliative Care of Pinellas County LLC Hospice and Palliative Medicine PastSince Oct 10, 2022 Accepting new patients

Locations

2644 Cypress Ridge Blvd
Ste 104
Wesley Chapel, FL 33544
Phone (813) 364-0311

2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599

2544 W Montrose Ave
Chicago, IL 60618
Phone (773) 267-2622

3435 W Van Buren St
Chicago, IL 60624
Phone (773) 265-7700

4058 W Melrose St
Chicago, IL 60641
Phone (773) 267-2622

6130 N Sheridan Rd
Chicago, IL 60660
Phone (773) 381-1222

7531 S Stony Island Ave
Chicago, IL 60649
Phone (773) 947-7310

1730 Park St
Ste 101
Naperville, IL 60563
Phone (630) 718-0200

365 E North Ave
Northlake, IL 60164
Phone (517) 273-1540

9525 Mayfield Ave
Oak Lawn, IL 60453
Phone (708) 636-7000

6400 Shafer Ct
Ste 700
Rosemont, IL 60018

2158 45th St
Highland, IN 46322
Phone (219) 554-0500

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1093780926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SHAFER CT STE 700",
            "city": "ROSEMONT",
            "state": "IL",
            "postal_code": "600184989",
            "telephone_number": "346-376-1702",
            "fax_number": "224-532-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17757 US HIGHWAY 19 N STE 175",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337646564",
            "telephone_number": "727-270-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKLA NAMAS",
        "first_name": "SHAKIB",
        "middle_name": "SHOKRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME47201",
            "primary": false
        },
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "IL",
            "license": "036087200",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036087200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.