NPIMap

Individual provider Active NPI

Sagar R. Shah, MD

  • Urology Physician
  • Jacksonville, FL
National Provider Identifier
1770604548
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME106303 Issued in FL
Practice address
710 Lomax St
Jacksonville, FL 32204-4004
Phone
(904) 355-6583
Fax
(904) 355-4922
NPI assigned
Apr 2, 2007
Last updated
Jul 21, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 000155 GA
Urology Physician 208800000X ME106303 FL Primary

Addresses

Primary practice location

710 Lomax St
Jacksonville, FL 32204-4004

Mailing address

710 Lomax St
Jacksonville, FL 32204-4004
Phone (904) 355-6583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000912 FL Practitioner - Urology 3577689348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical College of Georgia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14540 Old Saint Augustine Rd
Suite 2401
Jacksonville, FL 32258-7418
Phone (904) 880-4054

1715 Village Way
Orange Park, FL 32073-5263
Phone (904) 264-8418

710 Lomax St
Suite 1
Jacksonville, FL 32204-4004
Phone (904) 483-2310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of tissue1-10
Removal of the uterus14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000155GAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Physician Specialists LLC CurrentSince Jan 1, 2013 Accepting new patients
Florida Physician Specialists LLC Current Accepting new patients
Florida Physician Specialists LLC Urology CurrentSince Jan 1, 2013 Accepting new patients
McIver Urological Clinic Urology Current Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

710 Lomax St
Jacksonville, FL 32204
Phone (904) 306-6781

Interoperability endpoints

  • Direct secure messaging: sagarshah@miuc.allscriptsdirect.net

Organizations & group practices 5

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 7

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1770604548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 LOMAX ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044004",
            "telephone_number": "904-355-6583",
            "fax_number": "904-355-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 LOMAX ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044004",
            "telephone_number": "904-355-6583",
            "fax_number": "904-355-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SAGAR",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "000155",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME106303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.