Gregg Ian Shore, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

ME91364 Issued in FL

Practice address

4759 Lakeview Dr
Ste 101
Sebring, FL 33870-2005

Phone

(863) 402-5600

Fax

(863) 402-5602

NPI assigned

Jul 15, 2005

Last updated

Apr 9, 2017By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Enrolled in FL, AL2 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 2

Specialty

Colorectal Surgery (Proctology)Also: General Surgery

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

USA Vein Clinics of Miami LLCGroup PAC ID 9830404003, 11 clinicians

USA Vascular Centers of Miami PLLCGroup PAC ID 1557610862, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gregg.shore@direct.hvhc.org
• FHIR API: https://api.platform.athenahealth.com/1331/brand/1/csg/1/fhir/r4

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.

• USA Vascular Centers of Miami PLLC

  • Vascular Surgery Physician
  • Hallandale Beach, FL
  • NPI 1861884595
  Medicare reassignment Care Compare group NPD
• USA Vein Clinics of Miami, LLC

  • Vascular Surgery Physician
  • Hallandale Beach, FL
  • NPI 1396147138
  Medicare reassignment Care Compare group NPD
• Manuel E Abella MD PA

  • Cardiovascular Disease Physician
  • Miami, FL
  • NPI 1205275088
  Medicare reassignment NPD
• Russell Hospital Corporation

  dba Russell Medical Center

  • Family Medicine Physician
  • Alexander City, AL
  • NPI 1417252537
  Medicare reassignment NPD
• Russell Hospital Corporation

  • Rural Health Clinic/Center
  • New Site, AL
  • NPI 1700419868
  NPD
• General Surgery Associates LLC

  • Surgery Physician
  • Fort Myers, FL
  • NPI 1164250213
  NPD (past)
• Sebring Hospital Management Associates LLC

  dba Highlands Regional Medical Center

  • General Acute Care Hospital
  • Sebring, FL
  • NPI 1952344772
  NPD (past)
• St. Anthony's Specialists LLC

  • Surgery Physician
  • Clearwater, FL
  • NPI 1932143385
  NPD (past)
• Surgical Associates of West FL

  • Specialist
  • Safety Harbor, FL
  • NPI 1801839691
  NPD (past)
• USA Vascular Centers of Miami, PLLC

  • Vascular Surgery Physician
  • Miami, FL
  • NPI 1033984208
  NPD (past)
• Vascular Anesthesia Associates PLLC

  dba Vascular Anesthesia Associates

  • Certified Registered Nurse Anesthetist
  • Houston, TX
  • NPI 1346706173
  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491696000000",
    "number": "1235138983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4759 LAKEVIEW DR",
            "address_2": "STE 101",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338702005",
            "telephone_number": "863-402-5600",
            "fax_number": "863-402-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4759 LAKEVIEW DR",
            "address_2": "STE 101",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338702005",
            "telephone_number": "863-402-5600",
            "fax_number": "863-402-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "GREGG",
        "middle_name": "IAN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2017-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME91364",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME91364",
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "KS",
            "license": "0436711",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279783600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3710089",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PROVIDER NUMBER",
            "identifier": "P00603445",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• SHC Home Health Services - Lakeland, LLC (Signature HomeNow)
• Anthlesia Shepherd, RN
• Akaanksh Shetty, MD
• Shield Medical Group PLLC
• Thomas Shimshak, M.D.
• Ruth Short, RN C PSYCH MH
• Jenny Jane Shung, ARNP
• Ruthe Simon Thomas
• Glenn Murren Simpson, LMHC
• Rachel Sims, APRN

• Colon & Rectal Surgery Physician in Sebring, FL
• Providers in Sebring, FL by specialty
• Colon & Rectal Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2017; 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.