Individual provider Active NPI

Shahid Riaz, MD

  • Neurology Physician
  • Davenport, FL
National Provider Identifier
1891771119
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME75134 Issued in FL
Practice address
108 Park Place Blvd
Ste a
Davenport, FL 33837-6857
Phone
(863) 421-4700
Fax
(863) 421-4715
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME75134 FL Primary

Addresses

Primary practice location

108 Park Place Blvd
Ste a
Davenport, FL 33837-6857

Mailing address

108 Park Place Blvd
Ste a
Davenport, FL 33837-6857
Phone (863) 421-4700

Other identifiers 1

IdentifierTypeStateIssuer
258383600MedicaidFL

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
I20120118000026 FL Practitioner - General Practice 5991761413 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

108 Park Place Blvd
Suite a
Davenport, FL 33837-6857
Phone (863) 421-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Jul 1, 2020 Accepting new patients
The Neurodiagnostic Center of Central Florida PA CurrentSince Jul 1, 2003 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jul 1, 2020 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

108 Park Place Blvd
Ste A
Davenport, FL 33837
Phone (863) 271-4222

40124 Highway 27
Ste 204
Davenport, FL 33837
Phone (863) 419-2156

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

7300 Sandlake Commons Blvd
Ste 106
Orlando, FL 32819
Phone (407) 341-2986

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDAFBA/Endpoint/CDAFBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/DIDADD/Endpoint/DIDADD

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1891771119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 PARK PLACE BLVD",
            "address_2": "STE A",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376857",
            "telephone_number": "863-421-4700",
            "fax_number": "863-421-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 PARK PLACE BLVD",
            "address_2": "STE A",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376857",
            "telephone_number": "863-421-4700",
            "fax_number": "863-421-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIAZ",
        "first_name": "SHAHID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME75134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258383600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.