Khadijah Fatimah Shamseddine, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME118066 Issued in FL

Practice address

9730 Commerce Center CT
Fort Myers, FL 33908-3615

Phone

(239) 590-9190

Fax

(239) 989-0166

NPI assigned

Apr 7, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, SC, GA, VA, IN, PA6 enrollments

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 6

Specialty

Neurology

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Access Telecare PLLCGroup PAC ID 7810204831, 409 clinicians

Neurology Specialists, PA.Group PAC ID 3971582560, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trilogy Home Healthcare Home health agency, Estero, FL, CCN 108173
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
• Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075
• Tampa General Hospital Crystal River Hospital, Crystal River, FL, CCN 100249

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AEFCAA/Endpoint/AEFCAA

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.

• Neurology Specialists, PA.

  • Neurology Physician
  • Fort Myers, FL
  • NPI 1346303930
  Medicare reassignment Care Compare group NPD
• Access Telecare, PLLC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1013303080

  FL, GA, IN, PA, SC, VA

  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bridges Home Health Inc.

  dba Trilogy Home Healthcare

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1376517862
  Care Compare affiliation
• Lee Health System Inc

  dba Lee Memorial Hospital

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Lee Health System Inc

  dba Cape Coral Hospital

  • General Acute Care Hospital
  • Cape Coral, FL
  • NPI 1780429076
  Care Compare affiliation
• Tampa General Hospital Citrus LLC

  dba Tampa General Hospital Crystal River

  • General Acute Care Hospital
  • Crystal River, FL
  • NPI 1407637531
  Care Compare affiliation
• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1417247792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9730 COMMERCE CENTER CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083615",
            "telephone_number": "239-590-9190",
            "fax_number": "239-989-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 COMMERCE CENTER CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083615",
            "telephone_number": "239-590-9190",
            "fax_number": "239-989-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMSEDDINE",
        "first_name": "KHADIJAH",
        "middle_name": "FATIMAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-07",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME118066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael P. Shain, PH.D.
• Angela Shalabi Shalabi, RPH
• Shalimare Inc.
• Shalom Behavioral Wellness Center LLC.
• Isabella Mukanda Shamambo
• Ryan J. Shamus, P.A.
• Sara Shanahan, CNM
• Tamelyn Shane
• Cynthia Ann Shannon
• Dianna Marie Shannon, FNP-C

• Neurology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.