Individual provider Active NPI

Shamimara N Borachi, MD

  • Family Medicine Physician
  • New Port Richey, FL
National Provider Identifier
1508839564
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME66831 Issued in FL
Practice address
4759 US Highway 19
New Port Richey, FL 34652-4945
Phone
(727) 841-8772
Fax
(727) 848-5897
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME66831 FL Primary

Addresses

Primary practice location

4759 US Highway 19
New Port Richey, FL 34652-4945

Mailing address

4759 US Highway 19
New Port Richey, FL 34652-4945
Phone (727) 841-8772

Other identifiers 1

IdentifierTypeStateIssuer
375836200MedicaidFL

Other names 1

  • Shamimara Ashiqali Former name

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
I20100901000971 FL Practitioner - Family Practice 8224152913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

4759 US Hwy 19
New PT Richey, FL 34652-4945
Phone (727) 841-8772

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME66831FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida LLC Family Medicine CurrentSince Sep 28, 2000 Accepting new patients
Optumcare Florida, LLC CurrentSince Sep 28, 2000 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

3314 US Highway 19
Holiday, FL 34691
Phone (727) 845-0588

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

4759 US Highway 19
New Pt Richey, FL 34652
Phone (727) 841-8772

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: shamimara.borachi@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1508839564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4759 US HIGHWAY 19",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524945",
            "telephone_number": "727-841-8772",
            "fax_number": "727-848-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4759 US HIGHWAY 19",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524945",
            "telephone_number": "727-841-8772",
            "fax_number": "727-848-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORACHI",
        "first_name": "SHAMIMARA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME66831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375836200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAMIMARA",
            "last_name": "ASHIQALI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.