Organization Active NPI

Sean Shea MD PLLC

  • Psychiatry Physician
  • Miami Shores, FL
National Provider Identifier
1922718188
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SEAN SHEA MD PLLC
Practice address
1053 NE 95TH St
Miami Shores, FL 33138-2547
Phone
(786) 493-7792
NPI assigned
Nov 29, 2022
Last updated
Apr 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Authorized official

Name
Sean Shea, MDNPI 1760489397
Title
Sole Member
Phone
(786) 493-7792

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

1053 NE 95TH St
Miami Shores, FL 33138-2547

Mailing address

1053 NE 95TH St
Miami Shores, FL 33138-2547
Phone (727) 900-1326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221219000564 FL Part B Supplier - Clinic/Group Practice 1557730330 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL; Miami Beach, FL; Miami Shores, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1922718188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 NE 95TH ST",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382547",
            "telephone_number": "727-900-1326",
            "fax_number": "727-954-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 NE 95TH ST",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382547",
            "telephone_number": "786-493-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAN SHEA MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-29",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "786-493-7792",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.