Individual provider Active NPI

Sandra J Sha, MD

  • Radiation Oncology Physician
  • Lakeland, FL
National Provider Identifier
1396717328
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME85391 Issued in FL
Practice address
1730 Lakeland Hills Blvd
Lakeland, FL 33805
Phone
(863) 603-4770
Fax
(866) 264-8519
NPI assigned
Feb 3, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X ME85391 FL Primary

Addresses

Primary practice location

1730 Lakeland Hills Blvd
Lakeland, FL 33805

Mailing address

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssha6655@direct.watsonclinicad.com Watson Clinic LLP

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
I20040228000293 FL Practitioner - Radiation Oncology 2163319849 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Tufts University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watson Clinic LLPGroup PAC ID 1456258979, 365 clinicians
Central Florida Cancer Institute PAGroup PAC ID 5193612778, 4 clinicians

Practice addresses (Care Compare)

1730 Lakeland Hills Blvd
Lakeland, FL 33805-3013
Phone (863) 680-7780

2 State Rd 60
Lake Wales, FL 33853-4118
Phone (863) 679-2960

22 State Rd 60
Lake Wales, FL 33853-4118
Phone (863) 679-2960

40107 Hwy 27
Davenport, FL 33837
Phone (863) 419-0692

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.18 of 100Reported as apm
Quality
70.68
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME85391FLMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Cancer Institute PA CurrentSince Jan 5, 2004 Accepting new patients
Central Florida Cancer Institute PA CurrentSince Jan 5, 2004 Accepting new patients
Watson Clinic LLP CurrentSince Jan 12, 2004 Accepting new patients
Lakeland Regional Health Systems, Inc. CurrentSince Jul 9, 2013 Accepting new patients
Tampa Bay Radiation Oncology, PA Radiation Oncology Past Accepting new patients
Heysek & Kepes MDS PA Radiation Oncology Past Accepting new patients
NMC LLC Radiation Oncology Past Accepting new patients
Central Florida Cancer Institute PA Radiation Oncology Past Accepting new patients

Locations

40107 Highway 27
Davenport, FL 33837
Phone (863) 419-0692

1420 Celebration Blvd
Ste 308
Kissimmee, FL 34747
Phone (407) 566-9899

2 State Road 60 W
Lake Wales, FL 33853
Phone (863) 679-2960

130 Pablo St
Lakeland, FL 33803
Phone (863) 284-5064

1430 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7337

1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7190

1730 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 284-5040

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

5135 US Highway 98 N
Lakeland, FL 33809
Phone (941) 284-5998

3650 Emergency Ln
Sebring, FL 33870
Phone (800) 382-8345

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20634/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/_equjXi-I6k5_iN9ulQyh3xNMVDgQ7-w/
  • Direct secure messaging: sha@cfcancerinst.direct.varian.com
  • Direct secure messaging: ssha6655@direct.watsonclinicad.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1396717328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-603-4770",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHA",
        "first_name": "SANDRA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME85391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssha6655@direct.watsonclinicad.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Messaging Address",
            "affiliationName": "Watson Clinic LLP",
            "address_1": "1430 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338053202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.