Active NPI
Shahid M Nasir, MD
- Diagnostic Radiology Physician
- Ponte Vedra Beach, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- ME93304
- Practice address
- 1052 Ponte Vedra Blvd
Ponte Vedra Beach, FL 32082-4015 - Phone
- (904) 551-0703
- Fax
- (904) 551-0709
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD17542 | ME | |
| Diagnostic Radiology Physician | 2085R0202X | ME93304 | FL | Primary |
Addresses
Primary practice location
1052 Ponte Vedra Blvd
Ponte Vedra Beach, FL 32082-4015
Mailing address
130 Corridor Rd Unit 428
Ponte Vedra Beach, FL 32004-7718
Phone (907) 551-0703
Other practice location 1
24 Hospital Ln
Calais, ME 04619-1329
Phone (207) 454-7521
Other practice location 2
1680 Eagle Harbor Pkwy Ste A
Orange Park, FL 32003-4821
Phone (904) 264-9555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 276663900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Florida College of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
330 A1A N
Suite 322
Ponte Vedra Beach, FL 32082-1826
Phone (904) 551-0703
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD17542 | ME | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Down East Community Hospital | Current | Accepting new patients | |
| Adventhealth West Florida Imaging, Inc. | Current | Accepting new patients | |
| Diagnostic Imaging PA | Diagnostic Radiology | Current | Accepting new patients |
| Monument-9a Imaging & Diagnostic Center L L C | Current | Accepting new patients | |
| Calais Community Hospital | Current | Accepting new patients | |
| Down East Community Hospital | Current | Accepting new patients | |
| Womens' Health Hospitalists, LLC | Current | Accepting new patients | |
| Calais Community Hospital | Current | Accepting new patients | |
| Down East Community Hospital | Current | Accepting new patients | |
| Women's Care Florida LLC | Current | Accepting new patients | |
| First Coast Vein, LLC | Current | Accepting new patients | |
| Jacksonville Radiology Associates PA | Diagnostic Radiology | Past | Accepting new patients |
| Elite Imaging, LLC | Diagnostic Radiology | Past | Accepting new patients |
| Open MRI of Camden LLC | Diagnostic Radiology | Past | Accepting new patients |
Locations
1201 Monument Rd
Ste 101
Jacksonville, FL 32225
Phone (904) 855-0700
4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561
1680 Eagle Harbor Pkwy
Ste A
Orange Park, FL 32003
Phone (904) 264-9555
330 A1A N
Ste 322
Ponte Vedra Beach, FL 32082
Phone (904) 551-0703
130 Corridor Rd
Unit 428
Ponte Vedra Beach, FL 32004
330 A1A N
Ste 321
Ponte Vedra Beach, FL 32082
Phone (904) 280-0600
4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333
2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551
24 Hospital Ln
Calais, ME 04619
Phone (207) 454-9213
11 Hospital Dr
Machias, ME 04654
Phone (207) 255-0434
111 Stow Ave
Cuyahoga Fls, OH 44221
Phone (330) 564-2611
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/6b68bc92-a317-4686-a79a-fbb1b58a509e/
Organizations & group practices 14
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.
-
- Diagnostic Radiology Physician
- Ponte Vedra Beach, FL
- NPI 1285870089
-
- Obstetrics & Gynecology Physician
- Tampa, FL
- NPI 1013902923
-
- Obstetrics & Gynecology Physician
- Tampa, FL
- NPI 1205295599
-
- Critical Access Hospital
- Calais, ME
- NPI 1922001049
-
- Critical Access Hospital
- Machias, ME
- NPI 1528087004
-
- General Acute Care Hospital
- Machias, ME
- NPI 1689670242
-
dba AdventHealth Imaging Center Brandon
- Radiology Clinic/Center
- Brandon, FL
- NPI 1619500881
-
- Radiology Clinic/Center
- Jacksonville, FL
- NPI 1558375469
-
dba Baileyville Medical Center
- Rural Health Clinic/Center
- Baileyville, ME
- NPI 1467205112
-
- Medicare Defined Swing Bed Hospital Unit
- Machias, ME
- NPI 1336587542
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Calais, ME
- NPI 1922001049
-
- Critical Access Hospital
- Machias, ME
- NPI 1528087004
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633564800000",
"number": "1811904238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 CORRIDOR RD UNIT 428",
"city": "PONTE VEDRA BEACH",
"state": "FL",
"postal_code": "320047718",
"telephone_number": "907-551-0703",
"fax_number": "904-551-0709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1052 PONTE VEDRA BLVD",
"city": "PONTE VEDRA BEACH",
"state": "FL",
"postal_code": "320824015",
"telephone_number": "904-551-0703",
"fax_number": "904-551-0709"
}
],
"practiceLocations": [
{
"address_1": "24 Hospital Ln",
"address_purpose": "LOCATION",
"city": "Calais",
"state": "ME",
"postal_code": "046191329",
"country_code": "US",
"telephone_number": "207-454-7521",
"fax_number": "207-454-3616",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1680 Eagle Harbor Pkwy Ste A",
"address_purpose": "LOCATION",
"city": "Orange Park",
"state": "FL",
"postal_code": "320034821",
"country_code": "US",
"telephone_number": "904-264-9555",
"fax_number": "904-215-7960",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NASIR",
"first_name": "SHAHID",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2021-10-07",
"certification_date": "2021-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "ME",
"license": "MD17542",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME93304",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "276663900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ponte Vedra Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.