Individual provider Active NPI

Paul Sheikewitz, MD

  • Emergency Medicine Physician
  • St Augustine, FL
National Provider Identifier
1629165220
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G30422 Issued in CA
Practice address
110 Health Park Blvd
Saint Augustine, FL 32086-5776
Phone
(048) 233-4019
Fax
(904) 829-8649
NPI assigned
Oct 6, 2006
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G30422 CA Primary

Addresses

Primary practice location

110 Health Park Blvd
Saint Augustine, FL 32086-5776

Mailing address

PO Box 740861
Atlanta, GA 30374-0861
Phone (904) 819-4539

Other practice location 1

70 Turin Ter Ste 210
Saint Augustine, FL 32092-0850
Phone (904) 819-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20100614000268 CA Practitioner - Emergency Medicine 5496885709 Reassigns benefits to 1 organization
I20230321002299 FL Practitioner - Emergency Medicine 5496885709 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G30422CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flagler Professional Health Care Services, Inc. CurrentSince Oct 3, 2024 Accepting new patients
Emergency Medicine Specialists of Orange County Emergency Medicine CurrentSince Jul 1, 2003 Accepting new patients
Flagler Professional Health Care Services, Inc. Current Accepting new patients
Flagler Professional Health Care Services, Inc. Emergency Medicine Past Accepting new patients
James E. Pierog, MD, Inc. Past Accepting new patients

Locations

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

110 Health Park Blvd
St Augustine, FL 32086
Phone (904) 823-3401

70 Turin Ter
Ste 110
St Augustine, FL 32092
Phone (904) 819-7200

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1629165220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740861",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740861",
            "telephone_number": "904-819-4539",
            "fax_number": "904-819-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HEALTH PARK BLVD",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865776",
            "telephone_number": "048-233-4019",
            "fax_number": "904-829-8649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Turin Ter Ste 210",
            "address_purpose": "LOCATION",
            "city": "Saint Augustine",
            "state": "FL",
            "postal_code": "320920850",
            "country_code": "US",
            "telephone_number": "904-819-7200",
            "fax_number": "904-819-8936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEIKEWITZ",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G30422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.