NPIMap

Organization Active NPI

Humayun Shareef MD PA

  • Family Medicine Physician
  • Fort Pierce, FL
National Provider Identifier
1306147327
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05870 Issued in FL
Legal business name
HUMAYUN SHAREEF MD PA
Practice address
2401 Frist Blvd
Ste 1
Fort Pierce, FL 34950-4839
Phone
(772) 465-6979
Fax
(772) 465-4288
NPI assigned
Nov 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Authorized official

Name
Humayun Shareef, MD DONPI 1790843464
Title
Physician/Owner
Phone
(772) 465-6979

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 05870 FL Primary

Addresses

Primary practice location

2401 Frist Blvd
Ste 1
Fort Pierce, FL 34950-4839

Mailing address

2401 Frist Blvd
Ste 1
Fort Pierce, FL 34950-4839
Phone (772) 465-6979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110621000568 FL Part B Supplier - Clinic/Group Practice 5597943563 Receives reassigned benefits from 10 practitioners
Practice locations: Fort Pierce, FL; Port St. Lucie, FL

National Provider Directory

National Provider Directory

Locations

607 N 7th St
Fort Pierce, FL 34950
Phone (772) 465-6225

2401 Frist Blvd
Ste 1
Fort Pierce, FL 34950
Phone (772) 464-0033

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FJJBCA

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1306147327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 FRIST BLVD",
            "address_2": "STE 1",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504839",
            "telephone_number": "772-465-6979",
            "fax_number": "772-465-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 FRIST BLVD",
            "address_2": "STE 1",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504839",
            "telephone_number": "772-465-6979",
            "fax_number": "772-465-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAYUN SHAREEF MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "SHAREEF",
        "authorized_official_first_name": "HUMAYUN",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "772-465-6979",
        "authorized_official_credential": "MD DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "05870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.