NPIMap

Individual provider Active NPI

Satish P Shanbhag, MD,MPH

  • Hematology & Oncology Physician
  • Fleming Island, FL
National Provider Identifier
1215140454
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME143428 Issued in FL
Practice address
2370 Market Dr
Fleming Island, FL 32003-4326
Phone
(904) 264-6201
Fax
(904) 264-6858
NPI assigned
May 7, 2007
Last updated
May 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L2568 AL
Hematology & Oncology Physician 207RH0003X D70907 MD
Hematology & Oncology Physician 207RH0003X MT191302 PA
Hematology & Oncology Physician 207RH0003X ME143428 FL Primary

Addresses

Primary practice location

2370 Market Dr
Fleming Island, FL 32003-4326

Mailing address

7015 A C Skinner Pkwy Ste 1
Jacksonville, FL 32256-6932
Phone (904) 363-2113

Other practice location 1

4940 Eastern Ave
Baltimore, MD 21224-2735
Phone (410) 550-5850

Other identifiers 5

IdentifierTypeStateIssuer
L3890OtherFLMEDICARE
NHFDEOtherFLFLORIDA BLUE
652111800MedicaidMD
P02444215OtherFLRAILROAD MEDICARE
105246400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200124000222 FL Practitioner - Hematology/Oncology 4385769900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cancer Specialists LLCGroup PAC ID 9133377948, 46 clinicians

Practice addresses (Care Compare)

2370 Market Dr
Fleming Island, FL 32003-4326
Phone (904) 264-6201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L2568ALMDInternal Medicine Physician
D70907MDMDHematology & Oncology Physician
MT191302PAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Specialists, LLC Hematology & Oncology CurrentSince Mar 2, 2020 Accepting new patients
Cancer Specialists, LLC CurrentSince Mar 2, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2370 Market Dr
Fleming Island, FL 32003
Phone (904) 264-6201

5742 Booth Rd
Ste A
Jacksonville, FL 32207
Phone (904) 739-7779

7015 A C Skinner Pkwy
Ste 1
Jacksonville, FL 32256
Phone (904) 363-2113

Interoperability endpoints

  • Direct secure messaging: sshanbhag744045@direct.shands.ufl.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1215140454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 A C SKINNER PKWY STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566932",
            "telephone_number": "904-363-2113",
            "fax_number": "904-363-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 MARKET DR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034326",
            "telephone_number": "904-264-6201",
            "fax_number": "904-264-6858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4940 Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212242735",
            "country_code": "US",
            "telephone_number": "410-550-5850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANBHAG",
        "first_name": "SATISH",
        "middle_name": "P",
        "credential": "MD,MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "L2568",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MD",
            "license": "D70907",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PA",
            "license": "MT191302",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME143428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "L3890",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "NHFDE",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "652111800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P02444215",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105246400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.