Active NPI
Abubaker Shadoul Mohamed Farah, M.D.
- Internal Medicine Physician
- Tavares, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME171818
- Practice address
- 1000 Waterman Way
Tavares, FL 32778-5266 - Phone
- (352) 742-3578
- Fax
- (352) 742-3581
- NPI assigned
- May 25, 2022
- Last updated
- Aug 25, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Internal Medicine Physician | 207R00000X | ME171818 | FL | Primary |
Addresses
Primary practice location
1000 Waterman Way
Tavares, FL 32778-5266
Mailing address
770 W Granada Blvd Ste 101
Ormond Beach, FL 32174-5179
Phone (386) 231-4746
Other practice location 1
4201 St. Antoine
University Health Center, Suite 6A
Detroit, MI 48201
Phone (313) 745-4627
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Waterman Way
Tavares, FL 32778-5266
Phone (352) 742-3581
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Healthcare Partners, Inc | Internal Medicine | Current | Accepting new patients |
Locations
1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000
770 W Granada Blvd
Ste 101
Ormond Beach, FL 32174
Phone (386) 231-4519
60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000
1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- afarah5552861@adventhealth.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Daytona Beach, FL
- NPI 1780100529
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba AdventHealth Waterman
- General Acute Care Hospital
- Tavares, FL
- NPI 1821019571
-
dba Uf Health Emergency/Urgent Care Eustis Mt. Dora
- Urgent Care Clinic/Center
- Leesburg, FL
- NPI 1245001189
Hospital
-
- General Acute Care Hospital
- Leesburg, FL
- NPI 1245226190
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756080000000",
"number": "1104564525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 W GRANADA BLVD STE 101",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321745179",
"telephone_number": "386-231-4746",
"fax_number": "386-368-8927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 WATERMAN WAY",
"city": "TAVARES",
"state": "FL",
"postal_code": "327785266",
"telephone_number": "352-742-3578",
"fax_number": "352-742-3581"
}
],
"practiceLocations": [
{
"address_1": "4201 St. Antoine",
"address_2": "University Health Center, Suite 6A",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "48201",
"country_code": "US",
"telephone_number": "313-745-4627",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FARAH",
"first_name": "ABUBAKER",
"middle_name": "SHADOUL MOHAMED",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-25",
"last_updated": "2025-08-25",
"certification_date": "2025-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME171818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.