Individual provider Active NPI

Michael Timothy Shapiro, MD

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Las Vegas, NV
National Provider Identifier
1093992653
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
ME116072 Issued in FL
Practice address
7135 W Sahara Ave
Las Vegas, NV 89117-2873
Phone
(702) 222-9355
Fax
(702) 732-8540
NPI assigned
Jan 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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 63057 GA
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X ME116072 FL Primary
Family Medicine Physician 207Q00000X 13553 NV

Addresses

Primary practice location

7135 W Sahara Ave
Las Vegas, NV 89117-2873

Mailing address

2445 Lane Park Rd
Tavares, FL 32778-9648
Phone (863) 510-8366

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
I20131206000105 FL Practitioner - Family PracticePractitioner - Hospice/Palliative Care 1355488289 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13553NVMDFamily Medicine Physician
ME116072FLMDHospice and Palliative Medicine (Family Medicine) Physician
63057GAMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Health Services LLC Hospice and Palliative Medicine CurrentSince Jul 19, 2014 Accepting new patients
Cornerstone Health Services LLC CurrentSince Jul 19, 2014 Accepting new patients
Chapters Health Palliative Care, LLC CurrentSince Nov 1, 2023 Accepting new patients
Cornerstone Companion Services, LLC Past Accepting new patients
Health Services of Central Georgia, Inc Family Medicine PastSince Jun 1, 2004 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients

Locations

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

2445 Lane Park Rd
Tavares, FL 32778
Phone (866) 280-9355

12470 Telecom Dr
Ste 301
Temple Terrace, FL 33637
Phone (423) 707-8678

12470 Telecom Dr
Ste 300
Temple Terrace, FL 33637
Phone (813) 871-8111

2144 Welbilt Blvd
Trinity, FL 34655
Phone (727) 376-3658

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1093992653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 LANE PARK RD",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327789648",
            "telephone_number": "863-510-8366",
            "fax_number": "866-556-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7135 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172873",
            "telephone_number": "702-222-9355",
            "fax_number": "702-732-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MICHAEL",
        "middle_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-25",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "63057",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME116072",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "13553",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.