Individual provider Active NPI

Shira McMahan, D.O.

  • Neurology Physician
  • Stuart, FL
National Provider Identifier
1124339247
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OS 12230 Issued in FL
Practice address
3801 S Kanner Hwy Ste 200
Stuart, FL 34994-4801
Phone
(772) 419-3810
Fax
(772) 419-3811
NPI assigned
Jun 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X OS 12230 FL Primary

Addresses

Primary practice location

3801 S Kanner Hwy Ste 200
Stuart, FL 34994-4801

Mailing address

PO Box 417
Stuart, FL 34995-0417
Phone (772) 223-2832

Other identifiers 2

IdentifierTypeStateIssuer
012309500MedicaidFL
14V65OtherFLFLORIDA BLUE

Other names 1

  • Shira Anconina Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smcmahan41404@direct.martinhealth.org

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
I20140716001892 FL Practitioner - Neurology 7719100023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3801 S Kanner Hwy
FL 1
Stuart, FL 34994
Phone (772) 223-4999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS 12230FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Locations

3801 S Kanner Hwy
Ste 300
Stuart, FL 34994
Phone (772) 223-4978

3801 S Kanner Hwy
Fl 1
Stuart, FL 34994
Phone (772) 223-2832

509 SE Riverside Dr
Ste 305
Stuart, FL 34994
Phone (772) 221-2003

3801 S Kanner Hwy
Ste 200
Stuart, FL 34994
Phone (772) 223-4978

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

3801 S Kanner Hwy
Fl 2
Stuart, FL 34994
Phone (772) 223-4999

2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 689-5000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: smcmahando35895@direct.ccf.org

Organizations & group practices 2

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.

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": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1124339247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349950417",
            "telephone_number": "772-223-2832",
            "fax_number": "772-223-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S KANNER HWY STE 200",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944801",
            "telephone_number": "772-419-3810",
            "fax_number": "772-419-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHAN",
        "first_name": "SHIRA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "OS 12230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012309500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "14V65",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smcmahan41404@direct.martinhealth.org",
            "affiliation": "N",
            "address_1": "3801 S Kanner Hwy Ste 200",
            "city": "Stuart",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349944801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHIRA",
            "last_name": "ANCONINA",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.