Individual provider Active NPI

Shmaila Ishaq, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Lauderdale, FL
National Provider Identifier
1851375067
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME 107147 Issued in FL
Practice address
6405 N Federal Hwy
Suite 300
Fort Lauderdale, FL 33308-1412
Phone
(954) 958-5220
Fax
(954) 528-5218
NPI assigned
Dec 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X S0302 TX
Endocrinology, Diabetes & Metabolism Physician 207RE0101X S0302 TX
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME 107147 FL Primary

Addresses

Primary practice location

6405 N Federal Hwy
Suite 300
Fort Lauderdale, FL 33308-1412

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-4997

Other practice location 1

8233 N Sam Houston Pkwy E
Humble, TX 77396-2922
Phone (713) 442-2000

Other practice location 2

25553 Highway 59
Porter, TX 77365-6154
Phone (713) 442-2100

Other practice location 3

106 Vision Park Blvd
Shenandoah, TX 77384-3000
Phone (713) 442-1800

Other identifiers 2

IdentifierTypeStateIssuer
14H6MOtherFLBCBS
004054700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20211207001781 TX Practitioner - EndocrinologyPractitioner - Internal Medicine 4486618832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

106 Vision Park Blvd
Shenandoah, TX 77384-3000
Phone (713) 442-1800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 107147FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Internal Medicine CurrentSince Jan 24, 2022 Accepting new patients
Advanced Care Medical Center Inc Past Accepting new patients
Biogenetics Laboratories, Inc. Past Accepting new patients

Locations

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

8233 N Sam Houston Pkwy E
Humble, TX 77396
Phone (713) 442-2000

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

25553 Highway 59
Porter, TX 77365
Phone (713) 442-2100

106 Vision Park Blvd
Shenandoah, TX 77384
Phone (713) 442-1800

Interoperability endpoints

  • Direct secure messaging: sishaq40396@direct.kelsey-seybold.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1851375067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 N FEDERAL HWY",
            "address_2": "SUITE 300",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081412",
            "telephone_number": "954-958-5220",
            "fax_number": "954-528-5218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8233 N Sam Houston Pkwy E",
            "address_purpose": "LOCATION",
            "city": "Humble",
            "state": "TX",
            "postal_code": "773962922",
            "country_code": "US",
            "telephone_number": "713-442-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25553 Highway 59",
            "address_purpose": "LOCATION",
            "city": "Porter",
            "state": "TX",
            "postal_code": "773656154",
            "country_code": "US",
            "telephone_number": "713-442-2100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Vision Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Shenandoah",
            "state": "TX",
            "postal_code": "773843000",
            "country_code": "US",
            "telephone_number": "713-442-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISHAQ",
        "first_name": "SHMAILA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S0302",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "S0302",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME 107147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14H6M",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004054700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.