Organization Active NPI

Wesley Chapel Internal Medicine and Pediatrics, PA

  • Internal Medicine Physician
  • Wesley Chapel, FL
National Provider Identifier
1447447313
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME81346 Issued in FL
Legal business name
WESLEY CHAPEL INTERNAL MEDICINE AND PEDIATRICS, PA
Practice address
2038 Ashley Oaks Cir
Suite 102
Wesley Chapel, FL 33544-6413
Phone
(813) 929-3622
Fax
(813) 929-3620
NPI assigned
Sep 25, 2007
Last updated
Aug 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Authorized official

Name
Dr. Manish Shah, MDNPI 1902826035
Title
Doctor
Phone
(813) 929-3622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME81346 FL Primary
Pediatrics Physician 208000000X ME81346 FL

Addresses

Primary practice location

2038 Ashley Oaks Cir
Suite 102
Wesley Chapel, FL 33544-6413

Mailing address

2038 Ashley Oaks Cir
Suite 102
Wesley Chapel, FL 33544-6413
Phone (813) 929-3622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060131000499 FL Part B Supplier - Clinic/Group Practice 8628082559 Receives reassigned benefits from 5 practitioners
Practice locations: Wesley Chapel, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1049726Wesley Chapel Internal Medicine and Pediatrics PA2038 Ashley Oaks Cir Ste 102, Wesley Chapel, FL 33544Certificate of waiverJan 16, 2028

National Provider Directory

National Provider Directory

Locations

2038 Ashley Oaks Cir
Ste 102
Wesley Chapel, FL 33544
Phone (813) 929-3622

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346371200000",
    "number": "1447447313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2038 ASHLEY OAKS CIR",
            "address_2": "SUITE 102",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446413",
            "telephone_number": "813-929-3622",
            "fax_number": "813-929-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2038 ASHLEY OAKS CIR",
            "address_2": "SUITE 102",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446413",
            "telephone_number": "813-929-3622",
            "fax_number": "813-929-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY CHAPEL INTERNAL MEDICINE AND PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2012-08-31",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "813-929-3622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME81346",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME81346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.