Individual provider Active NPI

Samir Rameshchandra Shah, M.D.

  • Colon & Rectal Surgery Physician
  • Miami Lakes, FL
National Provider Identifier
1881893741
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
ME140999 Issued in FL
Practice address
5803 NW 151St St Ste 105
Miami Lakes, FL 33014-2473
Phone
(305) 596-3080
Fax
(305) 596-3073
NPI assigned
Jul 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 38018 SC
Colon & Rectal Surgery Physician 208C00000X 38018 SC
General Practice Physician 208D00000X ME140999 FL
Colon & Rectal Surgery Physician 208C00000X ME140999 FL Primary

Addresses

Primary practice location

5803 NW 151St St Ste 105
Miami Lakes, FL 33014-2473

Mailing address

9500 S Dadeland Blvd Ste 200
Miami, FL 33156-2866
Phone (305) 468-4185

Other practice location 1

2728 Sunset Blvd
Suite 104
West Columbia, SC 29169
Phone (803) 791-2722

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
I20190925002827 FL Practitioner - Colorectal Surgery (Proctology) 6507080736 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastro Health, LLCGroup PAC ID 2365440567, 246 clinicians

Practice addresses (Care Compare)

7765 Sw87Th Ave
Suite 212
Miami, FL 33173
Phone (305) 596-3080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.04 of 100Reported as group
Quality
65.4
Promoting interoperability
98
Improvement activities
40
Cost
76.41

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy11
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38018SCMDPharmacist
ME140999FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Minds Wellness Institute LLC CurrentSince Dec 1, 2024 Accepting new patients
Antares Mental Health Group LLC General Practice CurrentSince Dec 6, 2021 Accepting new patients
Gastro Health, LLC CurrentSince Nov 4, 2019 Accepting new patients
Gastro Health LLC Colon & Rectal Surgery CurrentSince Nov 4, 2019 Accepting new patients
Antares Mental Health Group LLC PastSince Feb 1, 2022 Accepting new patients
Pines Medical Clinic Past Accepting new patients
Galloway Anesthesia Associates LLC Past Accepting new patients

Locations

4675 Linton Blvd
Ste 202
Delray Beach, FL 33445
Phone (561) 495-5700

7769 NW 48th St
Ste 330
Doral, FL 33166
Phone (786) 332-4705

7100 W 20th Ave
Ste 301
Hialeah, FL 33016
Phone (305) 224-1864

7765 SW 87th Ave
Ste 212
Miami, FL 33173
Phone (305) 279-7546

9500 S Dadeland Blvd
Ste 200
Miami, FL 33156
Phone (786) 530-3820

3661 S Miami Ave
Ste 907
Miami, FL 33133
Phone (305) 856-7333

5803 NW 151st St
Ste 105
Miami Lakes, FL 33014
Phone (305) 596-3080

7243 Della Dr
Orlando, FL 32819
Phone (407) 381-7366

Organizations & group practices 7

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 5

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1881893741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 S DADELAND BLVD STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562866",
            "telephone_number": "305-468-4185",
            "fax_number": "305-596-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 NW 151ST ST STE 105",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142473",
            "telephone_number": "305-596-3080",
            "fax_number": "305-596-3073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2728 Sunset Blvd",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "29169",
            "country_code": "US",
            "telephone_number": "803-791-2722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SAMIR",
        "middle_name": "RAMESHCHANDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "38018",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "SC",
            "license": "38018",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME140999",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME140999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.