Individual provider Active NPI

Kevin Shah

  • Gastroenterology Physician
  • St Petersburg, FL
National Provider Identifier
1780147934
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME172716 Issued in FL
Practice address
5651 49TH St N
St Petersburg, FL 33709-2105
Phone
(727) 443-4299
NPI assigned
Apr 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME172716 FL
Gastroenterology Physician 207RG0100X ME172716 FL Primary

Addresses

Primary practice location

5651 49TH St N
St Petersburg, FL 33709-2105

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-6202

Other practice location 1

9800 S Healthpark Dr Ste 110
Fort Myers, FL 33908-3630
Phone (239) 343-6202

Other identifiers 1

IdentifierTypeStateIssuer
126542000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kshah673985@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20250618003032 FL Practitioner - GastroenterologyPractitioner - Hospitalist 3779812664 Reassigns benefits to 3 organizations
O20250625003939 FL Part B Supplier - Clinic/Group Practice 2163329251 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Petersburg, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Hospitalist
Education
University of South Florida College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Digestive SpecialistsGroup PAC ID 2163329251, 6 clinicians
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

5651 49TH St N
St Petersburg, FL 33709-2105
Phone (727) 443-4299

9800 S Healthpark Dr
Suite 110
Fort Myers, FL 33908-3630
Phone (239) 343-6202

Hospital & facility affiliations

  • HCA Florida Northside Hospital Hospital, Saint Petersburg, FL, CCN 100238
  • HCA Florida St Petersburg Hospital Hospital, Saint Petersburg, FL, CCN 100180
  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy42
Upper gastrointestinal (GI) endoscopy for acid reflux42

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mark T Howell DO PA CurrentSince Jul 22, 2025 Accepting new patients
Florida Digestive Specialists, PA CurrentSince Aug 1, 2025 Accepting new patients
Bay Area Endoscopy Center Limited Partnership CurrentSince Sep 1, 2025 Accepting new patients
Lee Health System Inc CurrentSince Jul 1, 2025 Accepting new patients
Lee Health System Inc CurrentSince Jul 1, 2025 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

9800 S Healthpark Dr
Ste 110
Fort Myers, FL 33908
Phone (239) 344-2307

5771 49th St N
St Petersburg, FL 33709
Phone (727) 443-4299

5651 49th St N
St Petersburg, FL 33709
Phone (727) 443-4299

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kshah673985@direct.leememorial.org

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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 and National Provider Directory roles.

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": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1780147934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-6202",
            "fax_number": "239-343-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092105",
            "telephone_number": "727-443-4299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9800 S Healthpark Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339083630",
            "country_code": "US",
            "telephone_number": "239-343-6202",
            "fax_number": "239-343-4159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME172716",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME172716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126542000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kshah673985@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.