Organization Active NPI

Ashok Shah MD PA

  • Internal Medicine Physician
  • Titusville, FL
National Provider Identifier
1720259930
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ASHOK SHAH MD PA
Practice address
3808 S Hopkins Ave
Titusville, FL 32780-5753
Phone
(321) 268-2005
Fax
(321) 264-2235
NPI assigned
Mar 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Dr. Ashok C Shah, MDNPI 1760476766
Title
Owner
Phone
(321) 268-2005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3808 S Hopkins Ave
Titusville, FL 32780-5753

Mailing address

3808 S Hopkins Ave
Titusville, FL 32780-5753
Phone (321) 268-2005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080513000590 FL Part B Supplier - Clinic/Group Practice 2567531825 Receives reassigned benefits from 1 practitioner
Practice locations: Titusville, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1083172Ashok Shah MD PA3808 S Hopkins Ave, Titusville, FL 32780Certificate of waiverApr 28, 2028

National Provider Directory

National Provider Directory

Locations

3808 S Hopkins Ave
Titusville, FL 32780
Phone (321) 268-2005

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1720259930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 S HOPKINS AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805753",
            "telephone_number": "321-268-2005",
            "fax_number": "321-264-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 S HOPKINS AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805753",
            "telephone_number": "321-268-2005",
            "fax_number": "321-264-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHOK SHAH MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "ASHOK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-268-2005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.