Individual provider Active NPI

Majid A Shams, PH.D.

  • Clinical Psychologist
  • Wellington, FL
National Provider Identifier
1922078179
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY4959 Issued in FL
Practice address
1035 S State Road 7
Suite 315-11
Wellington, FL 33414-6134
Phone
(561) 753-5997
NPI assigned
Jan 23, 2006
Last updated
Mar 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY4959 FL Primary

Addresses

Primary practice location

1035 S State Road 7
Suite 315-11
Wellington, FL 33414-6134

Mailing address

15940 Pine Strand CT
Wellington, FL 33414-6365
Phone (561) 753-5997

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110506000627 FL Practitioner - Clinical Psychologist 2365627338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cotler Healthcare and Development IncGroup PAC ID 0143121145, 25 clinicians

Practice addresses (Care Compare)

1035 S State Rd
7 Suite 315 11
Wellington, FL 33414-6134

15940 Pine Strand Court
Wellington, FL 33414-6365

15940 Pine Strand CT
Wellington, FL 33414-6365

315 S Flagler Dr
West Palm Beach, FL 33401-5613
Phone (561) 249-7835

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY4959FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cotler Healthcare & Development Inc. Clinical CurrentSince Aug 20, 2021 Accepting new patients
Majid a. Shams, PHD, PA Clinical CurrentSince Nov 10, 2010 Accepting new patients

Locations

901 S 62nd Ave
Hollywood, FL 33023
Phone (954) 893-0109

9835 Lake Worth Rd
Ste 16179
Lake Worth, FL 33467

12788 Forest Hill Blvd
Ste 1002
Wellington, FL 33414
Phone (561) 753-5997

315 S Flagler Dr
West Palm Beach, FL 33401
Phone (561) 655-8544

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1922078179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15940 PINE STRAND CT",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146365",
            "telephone_number": "561-753-5997",
            "fax_number": "561-795-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 S STATE ROAD 7",
            "address_2": "SUITE 315-11",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146134",
            "telephone_number": "561-753-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMS",
        "first_name": "MAJID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY4959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.