Individual provider Active NPI

Omar A Shah, MD

  • Internal Medicine Physician
  • Brooksville, FL
National Provider Identifier
1346942091
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME176059 Issued in FL
Practice address
11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone
(352) 592-2753
NPI assigned
Mar 20, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME176059 FL Primary

Addresses

Primary practice location

11375 Cortez Blvd
Brooksville, FL 34613-5409

Mailing address

11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone (352) 592-2753

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
I20260602004252 FL Practitioner - Internal Medicine 6103284419

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4121 Feldspar LN
Spring Hill, FL 34609-1842

5350 Spring Hill Dr
Spring Hill, FL 34606-4562

7228 Antares Dr
Gaithersburg, MD 20879-5427

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME176059FLMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: omar.shah@hca4.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1346942091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11375 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135409",
            "telephone_number": "352-592-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11375 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135409",
            "telephone_number": "352-592-2753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "OMAR",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME176059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

Verify at the official NPI Registry.