Individual provider Active NPI

Bhavesh A. Shah, M.D.

  • Family Medicine Physician
  • Sarasota, FL
National Provider Identifier
1255403663
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME145449 Issued in FL
Practice address
1921 Waldemere St Ste 405
Sarasota, FL 34239-2941
Phone
(941) 917-3500
Fax
(941) 917-3501
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-101053 IL
Family Medicine Physician 207Q00000X ME145449 FL Primary

Addresses

Primary practice location

1921 Waldemere St Ste 405
Sarasota, FL 34239-2941

Mailing address

PO Box 863407
Orlando, FL 32886-3407
Phone (941) 917-2600

Other practice location 1

351 Delnor Dr
Geneva, IL 60134-4222
Phone (630) 938-9900

Other identifiers 2

IdentifierTypeStateIssuer
F400268164OtherILMEDICARE PTAN INDIVIDUAL
920540OtherILMEDICARE PTAN GROUP

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200730003438 FL Practitioner - Family Practice 9436179504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians
H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians

Practice addresses (Care Compare)

1921 Waldemere St
Suite 405
Sarasota, FL 34239-2941
Phone (941) 917-3500

8220 Natures Way
Lakewood Ranch, FL 34202-4208
Phone (800) 699-9395

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME145449FLMDFamily Medicine Physician
036-101053ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Family Medicine CurrentSince Sep 21, 2020 Accepting new patients
Leroy Oaks Family Medicine, P.C. Family Medicine PastSince Feb 14, 2007 Accepting new patients
Sherman Hospital Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
SMH Physician Services Inc Past Accepting new patients

Locations

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1921 Waldemere St
Ste 405
Sarasota, FL 34239
Phone (941) 917-3500

Interoperability endpoints

  • Direct secure messaging: bhavesh.shah@fpg.directbygreenway.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1255403663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 WALDEMERE ST STE 405",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392941",
            "telephone_number": "941-917-3500",
            "fax_number": "941-917-3501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 Delnor Dr",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601344222",
            "country_code": "US",
            "telephone_number": "630-938-9900",
            "fax_number": "630-938-9930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "BHAVESH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-101053",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME145449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN INDIVIDUAL",
            "identifier": "F400268164",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN GROUP",
            "identifier": "920540",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.