Individual provider Active NPI

Sadia Zain Shah, M.D.

  • Pulmonary Disease Physician
  • Jacksonville, FL
National Provider Identifier
1760632806
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
53392 Issued in AZ
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Sep 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME134740 FL
Pulmonary Disease Physician 207RP1001X 62947 MN
Pulmonary Disease Physician 207RP1001X 35126763 OH
Pulmonary Disease Physician 207RP1001X 53392 AZ Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (480) 301-8000

Other practice location 1

200 1st St SW
Rochester, MN 55905-5452
Phone (507) 284-2511

Other practice location 2

13400 E Shea Blvd
Scottsdale, AZ 85259-5452
Phone (480) 301-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sshah383700@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, FL, MN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170530000921 AZ Practitioner - Pulmonary Disease 0648402412 Reassigns benefits to 1 organization
I20180403002055 FL Practitioner - Pulmonary Disease 0648402412 Reassigns benefits to 1 organization
I20180616000038 MN Practitioner - Pulmonary Disease 0648402412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

  • Mayo Clinic Hospital, Jacksonville, FL, CCN 100151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME134740FLMDPulmonary Disease Physician
62947MNMDPulmonary Disease Physician
35126763OHMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Arizona CurrentSince May 22, 2017 Accepting new patients
Mayo Clinic CurrentSince Jul 8, 2018 Accepting new patients
Mayo Clinic Current Accepting new patients
Mayo Clinic Arizona CurrentSince May 22, 2017 Accepting new patients
Mayo Clinic CurrentSince Jul 8, 2018 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Mar 19, 2018 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Mar 19, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

13400 E Shea Blvd
Scottsdale, AZ 85259

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Organizations & group practices 9

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": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1760632806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559055452",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13400 E Shea Blvd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852595452",
            "country_code": "US",
            "telephone_number": "480-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SADIA",
        "middle_name": "ZAIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME134740",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "62947",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35126763",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "53392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshah383700@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.