Individual provider Active NPI

Vinayasree Shyam, M.D.

  • Internal Medicine Physician
  • North Miami Beach, FL
National Provider Identifier
1700307766
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME151359 Issued in FL
Practice address
1431 NE 162ND St
North Miami Beach, FL 33162-4620
Phone
(305) 949-0999
NPI assigned
Jun 29, 2017
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME151359 FL Primary

Addresses

Primary practice location

1431 NE 162ND St
North Miami Beach, FL 33162-4620

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 653-1770

Other practice location 1

2601 Holme Avenue
Internal Medicine Residency
Philadelphia, PA 19152
Phone (267) 350-7403

Other practice location 2

20801 NW 2nd Ave
Miami, FL 33169-2103
Phone (305) 653-1770

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
I20210713001517 FL Practitioner - Internal Medicine 9032534433 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1700307766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-653-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 NE 162ND ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624620",
            "telephone_number": "305-949-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 Holme Avenue",
            "address_2": "Internal Medicine Residency",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19152",
            "country_code": "US",
            "telephone_number": "267-350-7403",
            "fax_number": "267-350-7441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20801 NW 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331692103",
            "country_code": "US",
            "telephone_number": "305-653-1770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHYAM",
        "first_name": "VINAYASREE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME151359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.