Active NPI
Shahed Hmeidan, PA
- Physician Assistant
- Orlando, FL
National Provider Identifier
1154969335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9112840
- Practice address
- 2624 Clementon Park CT
Orlando, FL 32835-6160 - Phone
- (321) 732-1769
- NPI assigned
- Dec 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9112840 | FL | Primary |
Addresses
Primary practice location
2624 Clementon Park CT
Orlando, FL 32835-6160
Mailing address
2624 Clementon Park CT
Orlando, FL 32835-6160
Phone (321) 732-1769
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2020 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9112840 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576627200000",
"number": "1154969335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2624 CLEMENTON PARK CT",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328356160",
"telephone_number": "321-732-1769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2624 CLEMENTON PARK CT",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328356160",
"telephone_number": "321-732-1769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HMEIDAN",
"first_name": "SHAHED",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-18",
"last_updated": "2019-12-18",
"certification_date": "2019-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9112840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.