NPIMap

Individual provider Active NPI

Sanjay B Shah, MD

  • Internal Medicine Physician
  • The Villages, FL
National Provider Identifier
1215986211
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME88746 Issued in FL
Practice address
1580 Santa Barbara Blvd
The Villages, FL 32159-6827
Phone
(352) 259-2159
Fax
(352) 259-5731
NPI assigned
May 8, 2006
Last updated
Jan 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME88746 FL Primary

Addresses

Primary practice location

1580 Santa Barbara Blvd
The Villages, FL 32159-6827

Mailing address

1580 Santa Barbara Blvd
The Villages, FL 32159-6827
Phone (352) 259-2159

Other practice location 1

3505 Progress Ln
Saint Cloud, FL 34769-6519
Phone (407) 891-8044

Other identifiers 1

IdentifierTypeStateIssuer
268538800MedicaidFL

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
I20040326000881 FL Practitioner - Internal Medicine 7618869447 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Premier Medical Associates All Florida LLCGroup PAC ID 2365418019, 10 clinicians
Premier Medical Associates of Florida Healthcare, PAGroup PAC ID 6800200940, 64 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378

11962 County Rd
101 Suite 104
The Villages, FL 32162-9336
Phone (352) 693-3378

1550 Killingsworth Way
The Villages, FL 32162-2175
Phone (352) 633-2971

1580 Santa Barbara Blvd
The Villages, FL 32159-6827
Phone (352) 259-2159

2953 Traverse TRL
The Villages, FL 32163-2017
Phone (352) 693-3378

5036 SE 110TH St
Suite 103
Belleview, FL 34420-3759
Phone (352) 693-3378

8768 SE 165TH Mulberry LN
Cora Physical Therapy Mulberry Lane
The Villages, FL 32162-5861
Phone (352) 329-5237

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Associates of Florida Healthcare, PA Internal Medicine CurrentSince Jan 8, 2021 Accepting new patients
Premier Medical Associates All Florida, LLC Internal Medicine CurrentSince Dec 18, 2018 Accepting new patients
Premier Medical Associates of Florida LLC Internal Medicine CurrentSince Jan 8, 2021 Accepting new patients
Premier Medical Associates of Florida LLC CurrentSince Jan 8, 2021 Accepting new patients
Quantum Inpatient Medical Services LLC CurrentSince May 1, 2020 Accepting new patients

Locations

1580 Santa Barbara Blvd
The Villages, FL 32159
Phone (352) 494-6882

910 Old Camp Rd
Ste 130
The Villages, FL 32162
Phone (352) 326-5254

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 6

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 10

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1215986211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SANTA BARBARA BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596827",
            "telephone_number": "352-259-2159",
            "fax_number": "352-259-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SANTA BARBARA BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596827",
            "telephone_number": "352-259-2159",
            "fax_number": "352-259-5731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505 Progress Ln",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "FL",
            "postal_code": "347696519",
            "country_code": "US",
            "telephone_number": "407-891-8044",
            "fax_number": "407-891-8016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SANJAY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME88746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268538800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.