NPIMap

Individual provider Active NPI

Shawn Edward Gough-Fibkins, MD

  • Diagnostic Radiology Physician
  • Miami, FL
National Provider Identifier
1346220035
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME 90529 Issued in FL
Practice address
9824 SW 133Rd CT
Miami, FL 33186-2203
Phone
(305) 382-4378
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME 90529 FL Primary

Addresses

Primary practice location

9824 SW 133Rd CT
Miami, FL 33186-2203

Mailing address

9824 SW 133Rd CT
Miami, FL 33186-2203
Phone (305) 382-4378

Other identifiers 1

IdentifierTypeStateIssuer
2792796MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080725000592 FL Practitioner - Diagnostic Radiology 9638269376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Maryland School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Broward Radiologists, P.a.Group PAC ID 9537141338, 25 clinicians

Practice addresses (Care Compare)

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Phone (954) 262-1140

201 E Sample Rd
Pompano Beach, FL 33064-3502
Phone (954) 946-2113

2300 N Commerce Pkwy
Suite 302
Weston, FL 33326-3255
Phone (954) 217-3300

3000 Coral Hills Dr
Coral Springs, FL 33065-4108
Phone (954) 946-2113

Hospital & facility affiliations

  • Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039
  • Broward Health North Hospital, Deerfield Beach, FL, CCN 100086
  • Broward Health Imperial Point Hospital, Fort Lauderdale, FL, CCN 100200
  • Broward Health Coral Springs Hospital, Coral Springs, FL, CCN 100276
  • Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.88
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 90529FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Broward Hospital District CurrentSince Sep 21, 2017 Accepting new patients
North Broward Radiologists, P.a. Diagnostic Radiology CurrentSince Jul 1, 2008 Accepting new patients
Penn Imaging Associates PC Diagnostic Radiology Past Accepting new patients
Albert J. Cook M.D. Inc Diagnostic Radiology Past Accepting new patients
Ohio Imaging Associates Inc Diagnostic Radiology Past Accepting new patients

Locations

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

Networks

  • Freedom Health HMO Network

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 9

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1346220035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9824 SW 133RD CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862203",
            "telephone_number": "305-382-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9824 SW 133RD CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862203",
            "telephone_number": "305-382-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGH-FIBKINS",
        "first_name": "SHAWN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME 90529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2792796",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.