Individual provider Active NPI

Shiva Seetahal, M.D.

  • Surgery Physician
  • Davenport, FL
National Provider Identifier
1720313364
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME 123621 Issued in FL
Practice address
40124 Highway 27
Suite 104
Davenport, FL 33837-5905
Phone
(863) 421-7626
NPI assigned
Oct 15, 2009
Last updated
Feb 16, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME 123621 FL Primary

Addresses

Primary practice location

40124 Highway 27
Suite 104
Davenport, FL 33837-5905

Mailing address

40124 Highway 27
Suite 104
Davenport, FL 33837-5905

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
I20151230001620 FL Practitioner - General Surgery 8224330782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

40124 Hwy 27
Suite 104
Davenport, FL 33837-5905
Phone (863) 421-7626

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 123621FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Surgery CurrentSince Sep 1, 2019 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients

Locations

1485 Legends Blvd
Champions Gate, FL 33896
Phone (407) 390-6480

40124 Highway 27
Ste 104
Davenport, FL 33837
Phone (863) 421-7626

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: sseetahal58915@adventhealth.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1720313364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40124 HIGHWAY 27",
            "address_2": "SUITE 104",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40124 HIGHWAY 27",
            "address_2": "SUITE 104",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375905",
            "telephone_number": "863-421-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEETAHAL",
        "first_name": "SHIVA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-15",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME 123621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.