Individual provider Active NPI

Mark Edward Shamis, M.D.

  • Family Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1710944855
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 30846 Issued in FL
Practice address
2140 Centerville PL
Tallahassee, FL 32308-4342
Phone
(850) 523-7455
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME 30846 FL Primary

Addresses

Primary practice location

2140 Centerville PL
Tallahassee, FL 32308-4342

Mailing address

PO Box 15349
Tallahassee, FL 32317-5349
Phone (850) 383-3300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.shamis.p1@direct.capitalhealthplan.nextgenshare.com

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
I20040311001096 FL Practitioner - Family Practice 9638068364 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 30846FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc Family Medicine CurrentSince Feb 24, 2018 Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Capital Health Plan, Inc, CurrentSince Jan 1, 2004 Accepting new patients
Tallahassee Memorial Healthcare Inc Family Medicine CurrentSince Feb 24, 2018 Accepting new patients

Locations

2140 Centerville Rd
Tallahassee, FL 32308
Phone (850) 383-3300

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1491 Governors Square Blvd
Tallahassee, FL 32301
Phone (850) 383-3300

1301 Hodges Dr
Tallahassee, FL 32308
Phone (850) 431-5430

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1710944855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15349",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323175349",
            "telephone_number": "850-383-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 CENTERVILLE PL",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084342",
            "telephone_number": "850-523-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMIS",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 30846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.shamis.p1@direct.capitalhealthplan.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2140 Centerville Pl",
            "city": "Tallahassee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "323084342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.