Individual provider Active NPI

Jainam Ruchir Shah

  • Anesthesiologist Assistant
  • Jacksonville, FL
National Provider Identifier
1811735103
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA1003 Issued in FL
Practice address
1 Shircliff Way
Jacksonville, FL 32204-4748
Phone
(904) 308-7300
NPI assigned
Jul 19, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 367H00000X AA1003 FL Primary

Addresses

Primary practice location

1 Shircliff Way
Jacksonville, FL 32204-4748

Mailing address

1 Shircliff Way
Jacksonville, FL 32204-4748

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241021004423 FL Practitioner - Anesthesiology Assistant 2264964865 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Anesthesia Consultants IncGroup PAC ID 7416869565, 110 clinicians
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (954) 939-5000

6401 N Federal Hwy
Fort Lauderdale, FL 33308-1427
Phone (954) 939-5000

Hospital & facility affiliations

  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040
  • Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321
  • Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
  • Broward Health Imperial Point Hospital, Fort Lauderdale, FL, CCN 100200
  • Ascension St Vincent'S St Johns County Hospital, St. Johns, FL, CCN 100361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA1003FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Single Specialty Current Accepting new patients
Sheridan Healthcorp Inc CurrentSince Sep 1, 2025 Accepting new patients
North Florida Anesthesia Consultants, Inc. CurrentSince Oct 14, 2024 Accepting new patients
North Florida Anesthesia Consultants Inc Single Specialty Current Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Sep 1, 2025 Accepting new patients
North Florida Anesthesia Consultants Inc CurrentSince Oct 14, 2024 Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

6401 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 776-8500

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

Organizations & group practices 6

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 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": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1811735103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748",
            "telephone_number": "904-308-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JAINAM",
        "middle_name": "RUCHIR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-19",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA1003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.