NPIMap

Individual provider Active NPI

Shyam Jaikishin Uttamchandani, M.D.

  • Nephrology Physician
  • Temple Terrace, FL
National Provider Identifier
1679785117
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME107798 Issued in FL
Practice address
12662 Telecom Dr
Temple Terrace, FL 33637-0935
Phone
(813) 908-8607
Fax
(855) 852-7153
NPI assigned
May 4, 2007
Last updated
Apr 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME107798 FL Primary

Addresses

Primary practice location

12662 Telecom Dr
Temple Terrace, FL 33637-0935

Mailing address

12662 Telecom Dr
Temple Terrace, FL 33637-0935
Phone (813) 908-8607

Other identifiers 1

IdentifierTypeStateIssuer
002457600MedicaidFL

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
I20101022000758 FL Practitioner - NephrologyPractitioner - Internal Medicine 2769576735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Florida College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

12662 Telecom Dr
Temple Terrace, FL 33637-0935
Phone (813) 910-0030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
70.52
Promoting interoperability
100
Improvement activities
40
Cost
73.91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians , LLC Nephrology CurrentSince Oct 11, 2016 Accepting new patients
Brandon Nephrology PA Nephrology Current Accepting new patients
Florida Kidney Physicians, LLC Nephrology CurrentSince Oct 11, 2016 Accepting new patients
Isabel Mathieson DO PA Past Accepting new patients

Locations

2501 Paul Buchman Hwy
Ste A
Plant City, FL 33563

3140 S Falkenburg Rd
Ste 201
Riverview, FL 33578
Phone (480) 610-6136

946 Cypress Village Blvd
Ste A
Ruskin, FL 33573

3909 Galen Ct
Ste 102
Sun City Ctr, FL 33573
Phone (813) 634-5502

409 Bayshore Blvd
Fl 4
Tampa, FL 33606
Phone (813) 910-8708

4710 N Habana Ave
Ste 107
Tampa, FL 33614
Phone (813) 870-3767

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

27802 Summergate Blvd
Wesley Chapel, FL 33544

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
  • Direct secure messaging: shyam.uttamchandani.1@15644.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1679785117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12662 TELECOM DR",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370935",
            "telephone_number": "813-908-8607",
            "fax_number": "855-852-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12662 TELECOM DR",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370935",
            "telephone_number": "813-908-8607",
            "fax_number": "855-852-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTTAMCHANDANI",
        "first_name": "SHYAM",
        "middle_name": "JAIKISHIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME107798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002457600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.