Individual provider Active NPI

Robert Shefsky, M.D.

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • St Petersburg, FL
National Provider Identifier
1720185465
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
ME 53437 Issued in FL
Practice address
1201 5TH Ave N
St Petersburg, FL 33705-1400
Phone
(727) 825-1183
Fax
(727) 825-1180
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X ME 53437 FL Primary

Addresses

Primary practice location

1201 5TH Ave N
St Petersburg, FL 33705-1400

Mailing address

4505 Bedford CT E
Bradenton, FL 34203-4057
Phone (941) 739-8129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 53437FLMDSports Medicine (Neuromusculoskeletal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720185465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 BEDFORD CT E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342034057",
            "telephone_number": "941-739-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051400",
            "telephone_number": "727-825-1183",
            "fax_number": "727-825-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEFSKY",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME 53437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.