Michael Jay Scott Sheridan, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

01069765A Issued in IN

Practice address

1116 N 16TH St Ste a
Lafayette, IN 47904

Phone

(765) 448-8000

Fax

(765) 448-8807

NPI assigned

Sep 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in FL, IN, GA, AR4 enrollments

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 4

Specialty

Cardiac SurgeryAlso: Thoracic Surgery

Education

University of Texas Medical School at Houston, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
• Novant Health Hilton Head Medical Center Hospital, Hilton Head Island, SC, CCN 420080
• Indiana University Health Ball Memorial Hospital Hospital, Muncie, IN, CCN 150089

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4692/brand/27/csg/1/fhir/r4
• Direct secure messaging: michael.sheridan.1@9582.direct.athenahealth.com

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.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment Care Compare group NPD
• Arnett Clinic, LLC

  • Internal Medicine Physician
  • Lafayette, IN
  • NPI 1164490843
  Medicare reassignment NPD
• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment NPD
• Savannah Multispecialty Associates, LLC

  • Trauma Surgery Physician
  • Savannah, GA
  • NPI 1528571320
  Medicare reassignment NPD
• West Florida Cardiology Network, LLC

  • Cardiovascular Disease Physician
  • Saint Petersburg, FL
  • NPI 1801198023
  Medicare reassignment NPD
• Arnett Clinic, LLC

  • Durable Medical Equipment & Medical Supplies
  • Lafayette, IN
  • NPI 1699839563
  NPD
• Arnett Clinic, LLC

  • Clinical Medical Laboratory
  • Lafayette, IN
  • NPI 1881655090
  NPD
• Mercy Clinic Fort Smith Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Smith, AR
  • NPI 1790258002
  NPD
• Phoebe Dorminy Surgical Associates

  • Clinic/Center
  • Fitzgerald, GA
  • NPI 1164703781
  NPD
• Cardiology Consultants

  • Specialist
  • St Petersburg, FL
  • NPI 1811940802
  NPD (past)
• Carolinas Medical Alliance, Inc

  • Rural Health Clinic/Center
  • Pamplico, SC
  • NPI 1023238490
  NPD (past)
• Fort Walton Beach Heart & Lung Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Shalimar, FL
  • NPI 1164443172
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Ball Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Muncie, IN
  • NPI 1225195340
  Care Compare affiliation
• Hilton Head Medical Center LLC

  • General Acute Care Hospital
  • Hilton Head Island, SC
  • NPI 1902675101
  Care Compare affiliation
• Sacred Heart Health System, Inc.

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1174519466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5545",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479035545",
            "telephone_number": "765-448-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 N 16TH ST STE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47904",
            "telephone_number": "765-448-8000",
            "fax_number": "765-448-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "MICHAEL",
        "middle_name": "JAY SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "GA",
            "license": "79395",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME 87486",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "01069765A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "78677",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "841624482",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000851467",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266749500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201023730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill E Shelby, NP
• Amanda Shelton, LMHC
• William D Shelton, DC
• Minqian Shen
• Heidi Ann Shenk, PT
• Tyler Allen Sherman, CSFA
• Brittany Sherron
• Ketan K Sheth, MD
• Cleveland G. Shields, PH.D.
• Paul Y Shin, MD

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; 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.

Verify at the official NPI Registry.