Individual provider Active NPI

Tulsi G. Shah, MD

  • Pulmonary Disease Physician
  • Clermont, FL
National Provider Identifier
1851829246
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME161201 Issued in FL
Practice address
1920 Don Wickham Dr Ste 335
Clermont, FL 34711-1978
Phone
(321) 841-7856
Fax
(321) 843-6432
NPI assigned
May 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME161201 FL Primary
Internal Medicine Physician 207R00000X 64940 CO

Addresses

Primary practice location

1920 Don Wickham Dr Ste 335
Clermont, FL 34711-1978

Mailing address

1920 Don Wickham Dr Ste 335
Clermont, FL 34711-1978
Phone (321) 841-7856

Other practice location 1

1400 Jackson St
Denver, CO 80206-2761
Phone (303) 388-4461

Other identifiers 1

IdentifierTypeStateIssuer
120191400MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NJHealth@njc.allscriptsdirect.net

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
I20231104000068 FL Practitioner - Pulmonary Disease 9234409848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1920 Don Wickham Dr
Suite 335
Clermont, FL 34711-1978
Phone (352) 536-8644

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64940COMDInternal Medicine Physician
ME161201FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Nov 1, 2023 Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients

Locations

1920 Don Wickham Dr
Ste 125
Clermont, FL 34711
Phone (407) 841-1290

1920 Don Wickham Dr
Ste 335
Clermont, FL 34711
Phone (352) 389-0605

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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 4

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": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1851829246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 DON WICKHAM DR STE 335",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111978",
            "telephone_number": "321-841-7856",
            "fax_number": "321-843-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 DON WICKHAM DR STE 335",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111978",
            "telephone_number": "321-841-7856",
            "fax_number": "321-843-6432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802062761",
            "country_code": "US",
            "telephone_number": "303-388-4461",
            "fax_number": "303-270-2206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "TULSI",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME161201",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "64940",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120191400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NJHealth@njc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1400 Jackson St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802062761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.