Individual provider Active NPI

Sherwat Abdelrahman, MD

  • Pediatrics Physician
  • Jacksonville, FL
National Provider Identifier
1801249636
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME155585 Issued in FL
Practice address
11261 San Jose Blvd
Jacksonville, FL 32223-7230
Phone
(904) 292-9033
Fax
(904) 390-7499
NPI assigned
Jul 17, 2016
Last updated
Jan 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD469016 PA
Pediatrics Physician 208000000X ME155585 FL Primary

Addresses

Primary practice location

11261 San Jose Blvd
Jacksonville, FL 32223-7230

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-1032

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sherwat.n.abdelrahman@upmcdirect.com UPMC

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912001892 FL Practitioner - Pediatric Medicine 5890129035 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME155585FLMDPediatrics Physician
MD469016PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Sep 1, 2022 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Sep 1, 2022 Accepting new patients
Children's Community Care Pediatrics PastSince May 10, 2020 Accepting new patients
Baptist Primary Care Inc Pediatrics Past Accepting new patients
Childrens Community Pediatrics Pediatrics PastSince Apr 1, 2020 Accepting new patients

Locations

3200 3rd St S
Jacksonville Beach, FL 32250
Phone (904) 450-7050

3200 3rd St S
Ste 101
Jax Bch, FL 32250
Phone (904) 247-4070

Interoperability endpoints

  • Direct secure messaging: sabdelrahman135588@baptisthealthsystemjacksonville.direct-ci.com
  • Direct secure messaging: sherwat.n.abdelrahman@upmcdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1468713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1801249636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11261 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237230",
            "telephone_number": "904-292-9033",
            "fax_number": "904-390-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELRAHMAN",
        "first_name": "SHERWAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-17",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD469016",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME155585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sherwat.n.abdelrahman@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.