NPIMap

Organization Active NPI

SMH Physician Services Inc

  • Pediatric Adolescent Medicine Physician
  • Lakewood Ranch, FL
National Provider Identifier
1811364334
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
ME57672 Issued in FL
Legal business name
SMH PHYSICIAN SERVICES INC
Practice address
8430 Enterprise Cir
Suite 130
Lakewood Ranch, FL 34202-4107
Phone
(941) 366-3000
Fax
(941) 366-3002
NPI assigned
Sep 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Authorized official

Name
Ilene Gilbert-Droge
Title
Coo
Phone
(947) 917-8720

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080A0000X ME80960 FL
Pediatric Adolescent Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080A0000X ME57672 FL Primary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080A0000X ME88696 FL
Pediatric Adolescent Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080A0000X ME22185 FL
Pediatric Adolescent Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080A0000X ME102035 FL

Addresses

Primary practice location

8430 Enterprise Cir
Suite 130
Lakewood Ranch, FL 34202-4107

Mailing address

PO Box 863407
Orlando, FL 32886-3407
Phone (941) 917-2600

Other identifiers 1

IdentifierTypeStateIssuer
33181OtherFLFLORIDA BLUE

Other names 1

  • First Physicians Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031231000211 FL Part B Supplier - Clinic/Group Practice 1355240177 Receives reassigned benefits from 1,046 practitioners
42 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sarasota, FL; Venice, FL; Osprey, FL; Lakewood Ranch, FL; North Port, FL; Bradenton, FL; North Venice, FL

Other NPIs on the same Medicare enrollment 42

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 42

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0296131SMH Physician Services Inc8430 Enterprise Cir Ste 130, Lakewood Ranch, FL 34202Certificate of waiverSep 8, 2026

National Provider Directory

National Provider Directory

Locations

8430 Enterprise Cir
Ste 130
Lakewood Ranch, FL 34202
Phone (941) 366-3000

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1811364334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 ENTERPRISE CIR",
            "address_2": "SUITE 130",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342024107",
            "telephone_number": "941-366-3000",
            "fax_number": "941-366-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMH PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "GILBERT-DROGE",
        "authorized_official_first_name": "ILENE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "947-917-8720"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME80960",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME57672",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME88696",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME22185",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME102035",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "33181",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Physicians Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood Ranch, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.