Individual provider Active NPI

Beejal Shah, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Tampa, FL
National Provider Identifier
1104065382
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME130530 Issued in FL
Practice address
13801 Bruce B Downs Blvd Ste 201
Tampa, FL 33613-3937
Phone
(813) 977-5557
Fax
(813) 972-9211
NPI assigned
Feb 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME130530 FL Primary

Addresses

Primary practice location

13801 Bruce B Downs Blvd Ste 201
Tampa, FL 33613-3937

Mailing address

13801 Bruce B Downs Blvd Ste 201
Tampa, FL 33613-3937
Phone (813) 977-5557

Other practice location 1

10000 Bay Pines Blvd
Bay Pines, FL 33744-8200
Phone (727) 398-6661

Other identifiers 4

IdentifierTypeStateIssuer
11953648OtherFLCAQH
S33110OtherFLUPIN
ME130530OtherFLMEDICAL LIC #
JA3362OtherFLMCARE #

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
I20170804002502 FL Practitioner - Endocrinology 5193870251

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Edlc, LLC Endocrinology, Diabetes & Metabolism Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bshah@schandra.directglo.com

Organizations & group practices 1

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": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1104065382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 BRUCE B DOWNS BLVD STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133937",
            "telephone_number": "813-977-5557",
            "fax_number": "813-972-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 BRUCE B DOWNS BLVD STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133937",
            "telephone_number": "813-977-5557",
            "fax_number": "813-972-9211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10000 Bay Pines Blvd",
            "address_purpose": "LOCATION",
            "city": "Bay Pines",
            "state": "FL",
            "postal_code": "337448200",
            "country_code": "US",
            "telephone_number": "727-398-6661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "BEEJAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-12",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME130530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11953648",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "S33110",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LIC #",
            "identifier": "ME130530",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE #",
            "identifier": "JA3362",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.