Individual provider Active NPI

Edna Shifteh, PA

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1184720617
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115883 Issued in FL
Practice address
1475 NW 12TH Ave
Miami, FL 33136-1002
Phone
(305) 243-5302
NPI assigned
Sep 15, 2006
Last updated
Sep 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9115883 FL Primary

Addresses

Primary practice location

1475 NW 12TH Ave
Miami, FL 33136-1002

Mailing address

PO Box 409041
Atlanta, GA 30384-9041
Phone (800) 377-8721

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eshifteh333290@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040707000224 NY Practitioner - Physician Assistant 0244217321 Reassigns benefits to 2 organizations
I20230804000357 FL Practitioner - Physician Assistant 0244217321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1321 NW 14TH St
Umhc Uhealth Tower
Miami, FL 33125-1673
Phone (954) 210-1000

1321 NW 14TH St 200 W BLDG
Umhc Uhealth Tower
Miami, FL 33125-1673
Phone (305) 355-7777

1321 NW 14TH Street 1St FL
Umhc Uhealth Tower
Miami, FL 33125-1673
Phone (305) 243-2067

1475 NW 12TH
1 Umhc SCCC
Miami, FL 33136-1002
Phone (305) 243-8434

1475 NW 12TH Ave
Miami, FL 33136-1002

1475 NW 12TH Ave 1St FL
Miami, FL 33136-1002

1475 NW 12TH Ave 1St FLR
Miami, FL 33136-1002

1475 NW 12TH Ave 3Rd Floor
Umhc SCCC
Miami, FL 33136-1002
Phone (305) 243-8644

1475 NW 12TH Ave 4TH FLR Stem Cell
Umhc SCCC
Miami, FL 33136-1002
Phone (954) 831-2763

1475 NW 12TH Ave C
130 Umhc SCCC Alex's Place
Miami, FL 33136-1002
Phone (305) 243-6857

1475 NW 12TH Ave Courtelis Ctr
C021 Umhc SCCC
Miami, FL 33136-1002
Phone (305) 243-6387

1475 NW 12TH Ave Head and Neck Clinic
Umhc SCCC
Miami, FL 33136-1002
Phone (305) 585-7890

1475 NW 12TH Ave Opd
Umhc SCCC
Miami, FL 33136-1002
Phone (954) 493-8666

1601 NW 12TH Ave
Miami, FL 33136-1005

1601 NW 12TH Ave 1St FL
Miami, FL 33136-1005

1601 NW 12TH Ave 1St FLR
Miami, FL 33136-1005

1601 NW 12TH Ave Room
2060 MCCD
Miami, FL 33136-1005
Phone (305) 585-5635

1601 NW 12TH Avenue 5065 /
5TH Mailman Center for Child Development
Miami, FL 33136-1005
Phone (305) 243-6251

1611 NW 12 Ave
Miami, FL 33136-1005

1611 NW 12 TH Ave
Jackson Memorial Hospital
Miami, FL 33136-1005
Phone (305) 355-5000

1611 NW 12TH
3B Jackson Memorial Hospital Acc West
Miami, FL 33136-1005
Phone (305) 585-7476

1611 NW 12TH Ave 2ND FL
Miami, FL 33136-1005

1611 NW 12TH Ave 2ND FLR
Miami, FL 33136-1005

1611 NW 12TH Ave 5TH Floor
Acc Clinic West JMH
Miami, FL 33136-1005
Phone (305) 243-4211

1611 NW 12TH Ave Acc E
Miami, FL 33136-1005

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
009291NYMDPhysical Therapist
PA9115883FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Oct 2, 2017 Accepting new patients
New York University CurrentSince Nov 6, 2019 Accepting new patients
University of Miami CurrentSince Jul 1, 2023 Accepting new patients
University of Miami CurrentSince Jul 1, 2023 Accepting new patients
New York University Emergency Medicine CurrentSince Nov 6, 2019 Accepting new patients
Nes Medical Services of New York PC Emergency Medicine PastSince May 22, 2022 Accepting new patients
LMC Physician Services, PC Past Accepting new patients
University of Miami Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123

8714 5th Ave
Brooklyn, NY 11209
Phone (718) 630-8600

300 Community Dr
Manhasset, NY 11030

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: eshifteh333290@nyumc.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1184720617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 409041",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303849041",
            "telephone_number": "800-377-8721",
            "fax_number": "304-523-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFTEH",
        "first_name": "EDNA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eshifteh333290@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.