Organization Active NPI

Trinity Family Physicians PL

  • Family Medicine Physician
  • Trinity, FL
National Provider Identifier
1932391463
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRINITY FAMILY PHYSICIANS PL
Practice address
1817 Cypress Brook Dr
Suite 101
Trinity, FL 34655-4414
Phone
(727) 834-8377
Fax
(727) 834-8371
NPI assigned
Aug 17, 2007
Last updated
Apr 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Authorized official

Name
Dr. Amir Shirmohammad, MDNPI 1912060500
Title
Physician
Phone
(813) 494-5272

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1817 Cypress Brook Dr
Suite 101
Trinity, FL 34655-4414

Mailing address

1817 Cypress Brook Dr
Suite 101
Trinity, FL 34655-4414
Phone (727) 834-8377

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080314000035 FL Part B Supplier - Clinic/Group Practice 6305921321 Receives reassigned benefits from 6 practitioners
Practice locations: Trinity, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1084208Trinity Family Physicians1817 Cypress Brook Dr Ste 101, Trinity, FL 34655Certificate of waiverMay 18, 2028

National Provider Directory

National Provider Directory

Locations

1817 Cypress Brook Dr
Ste 101
Trinity, FL 34655
Phone (727) 376-9757

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 6

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": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1932391463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 CYPRESS BROOK DR",
            "address_2": "SUITE 101",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554414",
            "telephone_number": "727-834-8377",
            "fax_number": "727-834-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 CYPRESS BROOK DR",
            "address_2": "SUITE 101",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554414",
            "telephone_number": "727-834-8377",
            "fax_number": "727-834-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY FAMILY PHYSICIANS PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "SHIRMOHAMMAD",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "813-494-5272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.