Individual provider Active NPI

Shuchi Chaudhary, MD

  • Vascular Neurology Physician
  • Lake Wales, FL
National Provider Identifier
1962601336
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
ME133598 Issued in FL
Practice address
410 S 11TH St
Lake Wales, FL 33853-4203
Phone
(863) 678-2200
Fax
(863) 419-4185
NPI assigned
Jul 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME133598 FL
Vascular Neurology Physician 2084V0102X ME133598 FL Primary
Neurology Physician 2084N0400X 25667 OK
Vascular Neurology Physician 2084V0102X 25667 OK

Addresses

Primary practice location

410 S 11TH St
Lake Wales, FL 33853-4203

Mailing address

410 S 11TH St
Lake Wales, FL 33853-4203
Phone (863) 678-2200

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
I20180606002703 FL Practitioner - Neurology 0143464875 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1414 Kuhl Ave
Orlando, FL 32806-2008
Phone (407) 841-5111

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25667OKMDVascular Neurology Physician

Practice roles (6 of 8)

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Apr 1, 2021 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Apr 1, 2021 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

410 S 11th St
Lake Wales, FL 33853
Phone (863) 676-1433

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: schaudhary179504@orlandohealth.medalliesdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1962601336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534203",
            "telephone_number": "863-678-2200",
            "fax_number": "863-419-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534203",
            "telephone_number": "863-678-2200",
            "fax_number": "863-419-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUDHARY",
        "first_name": "SHUCHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME133598",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "FL",
            "license": "ME133598",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OK",
            "license": "25667",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "OK",
            "license": "25667",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

Verify at the official NPI Registry.