Individual provider Active NPI

Michael Shapiro

  • Surgical Physician Assistant
  • Lake Worth, FL
National Provider Identifier
1710575832
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
9116482 Issued in FL
Practice address
4560 Lantana Rd Ste 100
Lake Worth, FL 33463-6998
Phone
(561) 967-4400
Fax
(844) 959-0419
NPI assigned
Jan 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 9116482 FL Primary

Addresses

Primary practice location

4560 Lantana Rd Ste 100
Lake Worth, FL 33463-6998

Mailing address

1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512
Phone (772) 288-2400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230315001488 FL Practitioner - Physician Assistant 8921472994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 SE Monterey Rd
Stuart, FL 34994-4512

900 Village Square Xing
Suite 170
Palm Beach Gardens, FL 33410-4549
Phone (561) 627-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9116482FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Orthopaedics & Sports Medicine, PA CurrentSince May 31, 2024 Accepting new patients
South Florida Orthopaedics & Sports Medicine, PA CurrentSince May 31, 2024 Accepting new patients
South Florida Orthopaedics & Sports Medicine,PA Past Accepting new patients

Locations

4560 Lantana Rd
Ste 100
Lake Worth, FL 33463
Phone (561) 797-3422

900 Village Square Xing
Ste 170
Palm Beach Gardens, FL 33410

1050 SE Monterey Rd
Ste 400
Stuart, FL 34994

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.

Hospital & facility affiliations 1

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": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1710575832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD STE 400",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-288-2400",
            "fax_number": "772-419-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 LANTANA RD STE 100",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334636998",
            "telephone_number": "561-967-4400",
            "fax_number": "844-959-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-05",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9116482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.