Organization Active NPI

Quintessential Medical Associates LLC

  • Family Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1336814177
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
QUINTESSENTIAL MEDICAL ASSOCIATES LLC
Practice address
573 NW Lake Whitney PL Ste 103
Port St Lucie, FL 34986-1628
Phone
(833) 245-5633
Fax
(833) 962-6213
NPI assigned
Aug 13, 2021
Last updated
May 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Authorized official

Name
Dr. Mohammed J Shweikeh, MDNPI 1932548880
Title
Doctor
Phone
(951) 640-1941

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Sleep Medicine (Family Medicine) Physician 207QS1201X

Addresses

Primary practice location

573 NW Lake Whitney PL Ste 103
Port St Lucie, FL 34986-1628

Mailing address

PO Box 880854
Port St Lucie, FL 34988-0854
Phone (833) 245-5633

Other practice location 1

1700 S 23rd St
Fort Pierce, FL 34950-4803
Phone (772) 461-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210909002688 FL Part B Supplier - Clinic/Group Practice 8729484183 Receives reassigned benefits from 1 practitioner
Practice locations: Port St Lucie, FL
O20241015003901 CA Part B Supplier - Clinic/Group Practice 8729484183 Receives reassigned benefits from 1 practitioner
Practice locations: Camarillo, CA

National Provider Directory

National Provider Directory

Locations

1700 S 23rd St
#1
Fort Pierce, FL 34950

573 NW Lake Whitney Pl
Ste 103
Port St Lucie, FL 34986
Phone (833) 245-5633

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1336814177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880854",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349880854",
            "telephone_number": "833-245-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "573 NW LAKE WHITNEY PL STE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861628",
            "telephone_number": "833-245-5633",
            "fax_number": "833-962-6213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 S 23rd St",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349504803",
            "country_code": "US",
            "telephone_number": "772-461-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "QUINTESSENTIAL MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-13",
        "last_updated": "2022-05-03",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "SHWEIKEH",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "951-640-1941",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.