Individual provider Active NPI

Shreyas Sureshbhai Mistry, M.D.

  • Family Medicine Physician
  • Bay Shore, NY
National Provider Identifier
1447558614
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME122478 Issued in FL
Practice address
301 E Main St
Bay Shore, NY 11706-8408
Phone
(631) 968-3000
NPI assigned
Mar 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME122478 FL Primary
Family Medicine Physician 207Q00000X 0101257804 VA

Addresses

Primary practice location

301 E Main St
Bay Shore, NY 11706-8408

Mailing address

PO Box 947407
Atlanta, GA 30394-7407
Phone (941) 917-2600

Other practice location 1

1700 S Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-4896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL, VA, WV4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20130724000841 GA Practitioner - Family Practice 1557502184 Reassigns benefits to 2 organizations
I20180911003512 FL Practitioner - Family Practice 1557502184 Reassigns benefits to 2 organizations
I20190917000250 VA Practitioner - Family Practice 1557502184 Reassigns benefits to 2 organizations
I20210225002349 WV Practitioner - Family Practice 1557502184 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760

Hospital & facility affiliations

  • Sarasota Memorial Homecare Home health agency, Sarasota, FL, CCN 107710
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of West Virginia- TCG PLLC CurrentSince Feb 12, 2022 Accepting new patients
Hospitalist Medicine Physicians of Fredericksburg, LLC CurrentSince Jul 8, 2019 Accepting new patients
Sound Physicians Emergency Medicine of Georgia PC CurrentSince Aug 1, 2019 Accepting new patients
Hospitalist Medicine Physicians of West Virginia, PLLC Family Medicine CurrentSince Jan 11, 2021 Accepting new patients
Hospitalist Medicine Physicians of Virginia LLC Family Medicine CurrentSince Jul 8, 2019 Accepting new patients
SMH Physician Services Inc Family Medicine CurrentSince Feb 7, 2022 Accepting new patients
Hni Medical Services of Florida, LLC Family Medicine CurrentSince Nov 1, 2018 Accepting new patients
Hospitalist Medicine Physicians of West Virginia-Wheeling, PLLC CurrentSince Jan 11, 2021 Accepting new patients
Cogent Healthcare of Georgia PC Family Medicine CurrentSince Aug 1, 2019 Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

5731 Bee Ridge Rd
Sarasota, FL 34233
Phone (888) 221-2216

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

367 Clear Creek Pkwy
Lavonia, GA 30553
Phone (706) 356-7800

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

8260 Atlee Rd
Mechanicsvlle, VA 23116
Phone (804) 264-6000

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

2500 Hospital Dr
Martinsburg, WV 25401
Phone (304) 233-4134

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

2000 Eoff St
Wheeling, WV 26003
Phone (304) 234-0123

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 9

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 3

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": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1447558614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-968-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 S Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "34239",
            "country_code": "US",
            "telephone_number": "941-917-4896",
            "fax_number": "941-917-6884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "SHREYAS",
        "middle_name": "SURESHBHAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME122478",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101257804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.