Individual provider Active NPI

Vinit Ketan Shah, DPM

  • Foot & Ankle Surgery Podiatrist
  • Altamonte Springs, FL
National Provider Identifier
1770065583
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO4371 Issued in FL
Practice address
697 Douglas Ave
Altamonte Springs, FL 32714-2515
Phone
(321) 397-2699
Fax
(407) 926-0500
NPI assigned
Aug 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO4371 FL Primary

Addresses

Primary practice location

697 Douglas Ave
Altamonte Springs, FL 32714-2515

Mailing address

350 Engle St
Englewood, NJ 07631-1808

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240502000087 FL Practitioner - Podiatry 4385084748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Podiatry of Central Florida PAGroup PAC ID 1153491535, 7 clinicians

Practice addresses (Care Compare)

697 Douglas Ave
Altamonte Springs, FL 32714-2515
Phone (321) 397-2699

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue39
Removal of skin lesions19
Removal of nail tissue1193
Removal or shaving of skin growth57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO4371FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Podiatry of Central Florida PA CurrentSince Apr 1, 2024 Accepting new patients
Family Podiatry of Central Florida PA CurrentSince Apr 1, 2024 Accepting new patients

Locations

697 Douglas Ave
Altamonte Springs, FL 32714
Phone (407) 497-8446

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1770065583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "697 DOUGLAS AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142515",
            "telephone_number": "321-397-2699",
            "fax_number": "407-926-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "VINIT",
        "middle_name": "KETAN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.