Individual provider Active NPI

Shahram Mori, MD

  • Hematology & Oncology Physician
  • Orlando, FL
National Provider Identifier
1891001400
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
21041 Issued in NV
Practice address
2415 N Orange Ave Ste 601
Orlando, FL 32804-5558
Phone
(407) 303-2070
Fax
(407) 303-2071
NPI assigned
Aug 20, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R72223 AZ
Hematology (Internal Medicine) Physician 207RH0000X ME120835 FL
Hematology & Oncology Physician 207RH0003X R72223 AZ
Hematology & Oncology Physician 207RH0003X A124379 CA
Medical Oncology Physician 207RX0202X ME120835 FL
Hematology & Oncology Physician 207RH0003X 21041 NV Primary

Addresses

Primary practice location

2415 N Orange Ave Ste 601
Orlando, FL 32804-5558

Mailing address

3150 N Tenaya Way Ste 520
Las Vegas, NV 89128-0448
Phone (702) 962-2100

Other practice location 1

3150 N Tenaya Way Ste 520
Las Vegas, NV 89128-0448
Phone (702) 962-2100

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
I20140808000607 FL Practitioner - Medical Oncology 6103076740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2415 N Orange Ave
Orlando, FL 32804-5505

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R72223AZMDInternal Medicine Physician
ME120835FLMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Jul 25, 2014 Accepting new patients
Florida Hospital Medical Group Inc Family Medicine CurrentSince Jul 25, 2014 Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2501 N Orange Ave
Ste 581
Orlando, FL 32804
Phone (407) 303-1300

2501 N Orange Ave
Ste 601
Orlando, FL 32804

2415 N Orange Ave
Ste 601
Orlando, FL 32804
Phone (407) 303-2070

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: shahram.mori@hca3.eclinicaldirectplus.com
  • Direct secure messaging: smori1502622@adventhealth.direct-ci.com

Organizations & group practices 6

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 2

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": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1891001400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 N TENAYA WAY STE 520",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280448",
            "telephone_number": "702-962-2100",
            "fax_number": "702-962-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 N ORANGE AVE STE 601",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045558",
            "telephone_number": "407-303-2070",
            "fax_number": "407-303-2071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3150 N Tenaya Way Ste 520",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280448",
            "country_code": "US",
            "telephone_number": "702-962-2100",
            "fax_number": "702-962-5620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORI",
        "first_name": "SHAHRAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R72223",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "FL",
            "license": "ME120835",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "AZ",
            "license": "R72223",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A124379",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "ME120835",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NV",
            "license": "21041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.