NPIMap

Individual provider Active NPI

Thomas Shimshak, M.D.

  • Interventional Cardiology Physician
  • Sebring, FL
National Provider Identifier
1467567941
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME122398 Issued in FL
Practice address
4240 Sun N Lake Blvd
Suite 202
Sebring, FL 33872-1944
Phone
(863) 471-3926
Fax
(863) 385-3093
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X ME122398 FL Primary

Addresses

Primary practice location

4240 Sun N Lake Blvd
Suite 202
Sebring, FL 33872-1944

Mailing address

4240 Sun N Lake Blvd
Suite 202
Sebring, FL 33872-1944
Phone (863) 471-3926

Other identifiers 1

IdentifierTypeStateIssuer
30554100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150122001072 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4789660515 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Internal Medicine
Education
Medical College of Wisconsin, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health System-Sunbelt IncGroup PAC ID 0749232445, shared by 8 NPIs, 100 clinicians

Practice addresses (Care Compare)

4240 Sun N Lake Blvd
Suite 202
Sebring, FL 33872-1944
Phone (863) 471-3926

533 Carlton St
Wauchula, FL 33873-3407
Phone (863) 773-3101

Hospital & facility affiliations

  • Adventhealth Sebring Hospital, Sebring, FL, CCN 100109
  • Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052
  • Adventhealth Wauchula Hospital, Wauchula, FL, CCN 101300

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting87
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System-Sunbelt Inc CurrentSince Jan 1, 2015 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Jan 1, 2015 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Apr 15, 2015 Accepting new patients
Adventist Health System-Sunbelt Inc Interventional Cardiology Current Accepting new patients
The Christ Hospital Cardiovascular Associates LLC Interventional Cardiology Past Accepting new patients
Ohio Heart and Vascular Center, Inc Past Accepting new patients

Locations

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

4240 Sun N Lake Blvd
Ste 202
Sebring, FL 33872
Phone (863) 471-3926

4101 Sun N Lake Blvd
Sebring, FL 33872

533 Carlton St
Wauchula, FL 33873
Phone (863) 767-8256

522 Carlton St
Wauchula, FL 33873
Phone (863) 773-0975

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: tshimshak622180@adventhealth.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Adventhealth WauchulaWauchula, FL, CCN 101300 Hospital Corporate Director Dec 10, 2020
Adventhealth Wauchula-Swing BedWauchula, FL, CCN 10Z300 Hospital Corporate Director Dec 10, 2020
Adventhealth Family and Lifestyle Medicine Avon ParkAvon Park, FL, CCN 103449 Rural health clinic Corporate Director Dec 10, 2020
Adventhealth Family Medicine WauchulaWauchula, FL, CCN 103448 Rural health clinic Corporate Director Dec 10, 2020
Adventhealth Family Medicine FrostproofFrostproof, FL, CCN 103975 Rural health clinic Corporate Director Dec 10, 2020

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1467567941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 SUN N LAKE BLVD",
            "address_2": "SUITE 202",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721944",
            "telephone_number": "863-471-3926",
            "fax_number": "863-385-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 SUN N LAKE BLVD",
            "address_2": "SUITE 202",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721944",
            "telephone_number": "863-471-3926",
            "fax_number": "863-385-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMSHAK",
        "first_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME122398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30554100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.