Individual provider Active NPI

M Shami

  • Nurse Practitioner
  • The Villages, FL
National Provider Identifier
1386173649
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9328810 Issued in FL
Practice address
1580 Santa Barbara Blvd
The Villages, FL 32159-6827
Phone
(352) 259-2159
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9328810 FL Primary

Addresses

Primary practice location

1580 Santa Barbara Blvd
The Villages, FL 32159-6827

Mailing address

1580 Santa Barbara Blvd
The Villages, FL 32159-6827
Phone (352) 259-2159

Other practice location 1

401 N Wickham Rd. Suite S
Melbourne, FL 32935
Phone (321) 242-9031

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170711001541 FL Practitioner - Nurse Practitioner 9638448426 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Inpatient Services LLCGroup PAC ID 7810361524, 21 clinicians

Practice addresses (Care Compare)

1580 Santa Barbara Blvd
The Villages, FL 32159-6827
Phone (352) 259-2159

Hospital & facility affiliations

  • Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9328810FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Physicians Network Inc CurrentSince Jan 1, 2021 Accepting new patients
Wellness by Physicians, Inc. CurrentSince Jun 23, 2020 Accepting new patients
Wellness by Physicians, Inc. CurrentSince Jun 23, 2020 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Synergy Inpatient Services LLC CurrentSince Apr 4, 2023 Accepting new patients

Locations

6150 Diamond Centre Ct
Bldg 100
Fort Myers, FL 33912
Phone (239) 768-6896

773 Highway 466
Lady Lake, FL 32159
Phone (321) 274-1864

511 Medical Plaza Dr
Ste 101
Leesburg, FL 34748

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

1580 Santa Barbara Blvd
The Villages, FL 32159
Phone (352) 494-6882

Interoperability endpoints

  • Direct secure messaging: mshami343710@orlandohealth.medalliesdirect.net

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 1

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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1386173649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SANTA BARBARA BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596827",
            "telephone_number": "352-259-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SANTA BARBARA BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596827",
            "telephone_number": "352-259-2159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 N Wickham Rd. Suite S",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "32935",
            "country_code": "US",
            "telephone_number": "321-242-9031",
            "fax_number": "321-242-9035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAMI",
        "first_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9328810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.