Individual provider Active NPI

Shelli M Adam, P.A.C.

  • Medical Physician Assistant
  • Sarasota, FL
National Provider Identifier
1235262866
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 9103984 Issued in FL
Practice address
1217 S East Ave Ste 210
Sarasota, FL 34239-2329
Phone
(941) 366-4015
Fax
(941) 366-4125
NPI assigned
Mar 13, 2007
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 9103984 FL Primary

Addresses

Primary practice location

1217 S East Ave Ste 210
Sarasota, FL 34239-2329

Mailing address

1217 S East Ave Ste 210
Sarasota, FL 34239-2329
Phone (941) 366-4015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130912000034 FL Practitioner - Physician Assistant 8022252188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Digestive Health Specialists, LLPGroup PAC ID 6507054582, 86 clinicians

Practice addresses (Care Compare)

1217 S E Ave
Suite 210
Sarasota, FL 34239-2329
Phone (941) 366-4015

1886 59TH St W
Bradenton, FL 34209-4630
Phone (941) 794-1980

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9103984FLMDMedical Physician Assistant

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1235262866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 S EAST AVE STE 210",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392329",
            "telephone_number": "941-366-4015",
            "fax_number": "941-366-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 S EAST AVE STE 210",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392329",
            "telephone_number": "941-366-4015",
            "fax_number": "941-366-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAM",
        "first_name": "SHELLI",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "P.A.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9103984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.