Individual provider Active NPI

Shajeea Ajmal, MD

  • Internal Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1942430780
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME121810 Issued in FL
Practice address
1300 Miccosukee Rd
Hospitalists Group
Tallahassee, FL 32308-5054
Phone
(850) 431-4556
Fax
(850) 431-6315
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P4280 TX
Internal Medicine Physician 207R00000X ME121810 FL Primary

Addresses

Primary practice location

1300 Miccosukee Rd
Hospitalists Group
Tallahassee, FL 32308-5054

Mailing address

1300 Miccosukee Road
Hospitalists Group
Tallahassee, FL 32308-5054
Phone (850) 431-4556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151117002684 FL Practitioner - Internal Medicine 3779734389 Reassigns benefits to 1 organization
I20240109004021 AZ Practitioner - Internal Medicine 3779734389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4720 E Greenway Rd
Phoenix, AZ 85032-4355
Phone (602) 439-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME121810FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc CurrentSince Sep 13, 2016 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Jan 15, 2024 Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Jan 15, 2024 Accepting new patients
Tallahassee Memorial Healthcare Inc Family Medicine CurrentSince Sep 13, 2016 Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
GMG Health Systems Associates PA Family Medicine PastSince Dec 27, 2009 Accepting new patients

Locations

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

4720 E Greenway Rd
Phoenix, AZ 85032
Phone (602) 439-6000

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1609 Physicians Dr
Tallahassee, FL 32308
Phone (850) 431-4243

1309 Thomasville Rd
Tallahassee, FL 32303
Phone (850) 431-5910

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1942430780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE ROAD",
            "address_2": "HOSPITALISTS GROUP",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085054",
            "telephone_number": "850-431-4556",
            "fax_number": "850-431-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE RD",
            "address_2": "HOSPITALISTS GROUP",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085054",
            "telephone_number": "850-431-4556",
            "fax_number": "850-431-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJMAL",
        "first_name": "SHAJEEA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P4280",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME121810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.