Shiva Lakshmin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0093772 Issued in FL

Practice address

3625 University Blvd S
Emergency Department
Jacksonville, FL 32216-4207

Phone

(904) 346-3606

Fax

(904) 346-0113

NPI assigned

Jan 6, 2006

Last updated

Jul 23, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Family Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patients First Lake Ella Medical Center P aGroup PAC ID 4082760566, 23 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

50.88 of 100Reported as group

Quality

48.24

Promoting interoperability

0

Improvement activities

30

Cost

83.87

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Patients First Lake Ella Medical Center P a

  dba Patients First Lake Ella

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1164524039
  Medicare reassignment Care Compare group NPD
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment NPD
• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Medicare reassignment NPD
• Tallahassee Memorial Healthcare Inc

  dba TMH Physician Partners

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1366293102
  NPD
• Tallahassee Memorial Healthcare Inc

  • Internal Medicine Physician
  • Tallahassee, FL
  • NPI 1386862852
  NPD
• Tallahassee Memorial Healthcare Inc.

  • Family Medicine Physician
  • Quincy, FL
  • NPI 1811953128
  NPD
• Florida Em-I Medical Services, PA

  • Emergency Medicine Physician
  • Tallahassee, FL
  • NPI 1083046049
  NPD (past)
• Patients First Raymond Diehl Medical Center PA

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1295837169
  NPD (past)

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1851379184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860554",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328860554",
            "telephone_number": "904-346-3606",
            "fax_number": "904-346-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UNIVERSITY BLVD S",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164207",
            "telephone_number": "904-346-3606",
            "fax_number": "904-346-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKSHMIN",
        "first_name": "SHIVA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0093772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05108548",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1594881",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "29197",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "P00252893",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Paresh Lalcheta, MD
• Janet C Lam Hart, MD
• Jillian Elise Lam, PA-C
• Lindsey Rowland Lam, M. ED. CCC- SLP
• Loruanma Lam, DO

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.

Verify at the official NPI Registry.