Individual provider Active NPI

Shivan Ramsamooj

  • Internal Medicine Physician
  • Bradenton, FL
National Provider Identifier
1821618331
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS20181 Issued in FL
Practice address
206 2ND St E
Bradenton, FL 34208-1042
Phone
(718) 915-1939
NPI assigned
Apr 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS20181 FL Primary

Addresses

Primary practice location

206 2ND St E
Bradenton, FL 34208-1042

Mailing address

206 2ND St E
Bradenton, FL 34208-1000
Phone (718) 915-1939

Other practice location 1

1700 S Tamiami Trl
Sarasota, FL 34239-3509
Phone (941) 917-4896

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
I20230731000505 FL Practitioner - Internal Medicine 4880055409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760

Hospital & facility affiliations

  • Sarasota Memorial Homecare Home health agency, Sarasota, FL, CCN 107710
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Internal Medicine CurrentSince Sep 18, 2023 Accepting new patients

Locations

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1821618331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 2ND ST E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081000",
            "telephone_number": "718-915-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 2ND ST E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081042",
            "telephone_number": "718-915-1939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 S Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342393509",
            "country_code": "US",
            "telephone_number": "941-917-4896",
            "fax_number": "941-917-6884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMSAMOOJ",
        "first_name": "SHIVAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-24",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS20181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.