Individual provider Active NPI

Siddharth H Shah, M.D.

  • Neurology Physician
  • New Port Richey, FL
National Provider Identifier
1174510358
Registry record updated Aug 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME0068165 Issued in FL
Practice address
4738 Grand Blvd Ste C
New Port Richey, FL 34652-5170
Phone
(727) 848-0800
Fax
(727) 843-8157
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2026

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 ME0068165 FL Primary

Addresses

Primary practice location

4738 Grand Blvd Ste C
New Port Richey, FL 34652-5170

Mailing address

304 Tall Oak TRL
Tarpon Springs, FL 34688-7711
Phone (727) 848-0800

Other identifiers 1

IdentifierTypeStateIssuer
377497000MedicaidFL

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
I20051206000939 FL Practitioner - Neurology 0244122182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siddharth H Shah MD PAGroup PAC ID 7618869546, 2 clinicians

Practice addresses (Care Compare)

4738 Grand Blvd
Suite Bandc
New Port Richey, FL 34652-5170
Phone (727) 848-0800

Hospital & facility affiliations

  • HCA Florida Trinity Hospital Hospital, Trinity, FL, CCN 100191
  • Adventhealth North Pinellas Hospital, Tarpon Springs, FL, CCN 100055

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0068165FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shahab U Kidwai MD PA Neurology CurrentSince Feb 1, 2024 Accepting new patients
Siddharth H Shah MD PA Neurology CurrentSince Apr 2, 1998 Accepting new patients
Ismail M.D., P.a. Neurology PastSince Feb 1, 2024 Accepting new patients

Locations

4754 US Highway 19
New Port Richey, FL 34652
Phone (727) 848-0800

4762 Rowan Rd
New Port Richey, FL 34653
Phone (727) 848-0800

4738 Grand Blvd
Ste C
New Prt Rchy, FL 34652
Phone (727) 807-7800

4738 Grand Blvd
Ste Bc
New Prt Rchy, FL 34652
Phone (727) 848-0800

2000 N Federal Hwy
Ste 202
Pompano Beach, FL 33062
Phone (954) 782-6800

2000 N Federal Hwy
Ste 203
Pompano Beach, FL 33062
Phone (954) 783-0222

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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 2

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1174510358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 TALL OAK TRL",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346887711",
            "telephone_number": "727-848-0800",
            "fax_number": "727-843-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4738 GRAND BLVD STE C",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346525170",
            "telephone_number": "727-848-0800",
            "fax_number": "727-843-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SIDDHARTH",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME0068165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377497000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.