NPIMap

Organization Active NPI

SMH Physician Services Inc

Doing business as Siesta Key Med Assoc. - First Physicians Group of Sarasota

  • Internal Medicine Physician
  • Sarasota, FL
National Provider Identifier
1629069463
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SMH PHYSICIAN SERVICES INC
Doing business as
Siesta Key Med Assoc. - First Physicians Group of Sarasota
Practice address
5132 Ocean Blvd
Sarasota, FL 34242-1637
Phone
(941) 349-1411
Fax
(941) 346-0885
NPI assigned
Nov 1, 2005
Last updated
Feb 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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

Authorized official

Name
Ms. Della K Shaw
Title
Coo
Phone
(941) 917-8720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X FL Primary

Addresses

Primary practice location

5132 Ocean Blvd
Sarasota, FL 34242-1637

Mailing address

PO Box 863407
Orlando, FL 32886-3407
Phone (941) 349-1411

Other identifiers 1

IdentifierTypeStateIssuer
376537700MedicaidFL

Other names 1

  • Siesta Key Med Assoc. - First Physicians Group of Sarasota Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031231000211 FL Part B Supplier - Clinic/Group Practice 1355240177 Receives reassigned benefits from 1,046 practitioners
42 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sarasota, FL; Venice, FL; Osprey, FL; Lakewood Ranch, FL; North Port, FL; Bradenton, FL; North Venice, FL

Other NPIs on the same Medicare enrollment 42

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 42

National Provider Directory

National Provider Directory

Locations

5132 Ocean Blvd
Sarasota, FL 34242
Phone (941) 312-6708

NPI Registry JSON

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1629069463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-349-1411",
            "fax_number": "941-346-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5132 OCEAN BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342421637",
            "telephone_number": "941-349-1411",
            "fax_number": "941-346-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMH PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "DELLA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "941-917-8720",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376537700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Siesta Key Med Assoc. - First Physicians Group of Sarasota",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.