Individual provider Active NPI

Shela Bazile, ANP-BC, MSN, RN

  • Adult Health Nurse Practitioner
  • Deerfield Beach, FL
National Provider Identifier
1780022590
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP 9236018 Issued in FL
Practice address
800 Fairway Dr
Deerfield Beach, FL 33441-1828
Phone
(954) 606-5217
Fax
(888) 503-1690
NPI assigned
Jun 13, 2013
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 10007556 OR
Adult Health Nurse Practitioner 363LA2200X GAA-NP000009 GA
Adult Health Nurse Practitioner 363LA2200X 0024189534 VA
Adult Health Nurse Practitioner 363LA2200X ARNP 9236018 FL Primary

Addresses

Primary practice location

800 Fairway Dr
Deerfield Beach, FL 33441-1828

Mailing address

658 SW Dalton Cir
Port Saint Lucie, FL 34953-5813
Phone (772) 626-5937

Other identifiers 1

IdentifierTypeStateIssuer
ARNP9236018OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, OR, VA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210112002232 GA Practitioner - Nurse Practitioner 2668691353 Reassigns benefits to 1 organization
I20230608000571 OR Practitioner - Nurse Practitioner 2668691353 Reassigns benefits to 1 organization
I20240514002331 VA Practitioner - Nurse Practitioner 2668691353

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Area Hospital DistrictGroup PAC ID 2163331000, 117 clinicians

Practice addresses (Care Compare)

1775 Thompson Rd
Coos Bay, OR 97420-2125
Phone (541) 269-8280

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
87.45 of 100Reported as group
Quality
69.6
Promoting interoperability
100
Improvement activities
40
Cost
76.59

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
ARNP 9236018FLMDAdult Health Nurse Practitioner
GAA-NP000009GAMDAdult Health Nurse Practitioner
0024189534VAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Hospital District CurrentSince Jun 1, 2023 Accepting new patients
Bay Area Hospital District CurrentSince Jun 1, 2023 Accepting new patients
City of Hope Medical Group of Georgia LLC CurrentSince Nov 30, 2020 Accepting new patients

Locations

Dept LA 25339
Pasadena, CA 91185

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

62742 Collections Ctr Dr
Chicago, IL 60693

1775 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-8090

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

Organizations & group practices 3

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 6

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": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1780022590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 SW DALTON CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535813",
            "telephone_number": "772-626-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIRWAY DR",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411828",
            "telephone_number": "954-606-5217",
            "fax_number": "888-503-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZILE",
        "first_name": "SHELA",
        "name_prefix": "Mrs.",
        "credential": "ANP-BC, MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2025-01-08",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "10007556",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "GAA-NP000009",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024189534",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9236018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ARNP9236018",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.