Renae Shibata, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME163067 Issued in FL

Practice address

21 Columbia St Ste 101
Orlando, FL 32806-1133

Phone

(321) 841-6060

Fax

(321) 841-2442

NPI assigned

Mar 28, 2017

Sex

Female

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 1

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

Specialty

Obstetrics/Gynecology

Education

Oakland Univ, William Beaumont School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051

Merit-based Incentive Payment System (MIPS)

Final score

79.91 of 100Reported as group

Quality

61.18

Promoting interoperability

100

Improvement activities

40

Cost

71.86

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Orlando Health Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Winter Park, FL
  • NPI 1265019541
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Lake Hospital, Inc.

  dba Orlando Health South Lake Hospital

  • General Acute Care Hospital
  • Clermont, FL
  • NPI 1336221019
  Care Compare affiliation

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1275065518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 COLUMBIA ST STE 101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061133",
            "telephone_number": "321-841-6060",
            "fax_number": "321-841-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 COLUMBIA ST STE 101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061133",
            "telephone_number": "321-841-6060",
            "fax_number": "321-841-2442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Community Dr",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303816",
            "country_code": "US",
            "telephone_number": "516-562-4429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIBATA",
        "first_name": "RENAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "309052-01",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME163067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119187100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pooja J. Sheth, MD
• Purnima Jiten Sheth, BDS
• Shetka Ventures, LLC (Home Helpers Home Care of Winter Garden)
• Shruti Kishor Shettigar, MD
• Eric Shiar, DDS
• Tracy Shibla, APRN
• Whitney Brooke Shidler, CNM
• Shield of Colors LLC
• Ella Dawn Marie Shields
• Nastassia Elena Shields, DMD

• Obstetrics & Gynecology Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.