Individual provider Active NPI

Shubha Kollampare, MD

  • Rheumatology Physician
  • Clermont, FL
National Provider Identifier
1902154859
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
ME153239 Issued in FL
Practice address
2105 Hartwood Marsh Rd Ste 3
Clermont, FL 34711-5390
Phone
(347) 216-5347
NPI assigned
Aug 27, 2012
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X ME153239 FL Primary

Addresses

Primary practice location

2105 Hartwood Marsh Rd Ste 3
Clermont, FL 34711-5390

Mailing address

2105 Hartwood Marsh Rd Ste 3
Clermont, FL 34711-5390
Phone (352) 810-9073

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
I20220302000665 FL Practitioner - Rheumatology 6507121829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2105 Hartwood Marsh Rd
Suite 3
Clermont, FL 34711-5390
Phone (352) 810-9073

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
Radiant Rheumatology LLC Single Specialty CurrentSince Aug 27, 2025 Accepting new patients

Locations

2105 Hartwood Marsh Rd
Ste 3
Clermont, FL 34711
Phone (352) 810-9073

Interoperability endpoints

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

Organizations & group practices 1

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 1

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": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1902154859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 HARTWOOD MARSH RD STE 3",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347115390",
            "telephone_number": "352-810-9073",
            "fax_number": "352-810-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 HARTWOOD MARSH RD STE 3",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347115390",
            "telephone_number": "347-216-5347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLAMPARE",
        "first_name": "SHUBHA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "ME153239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.