Active NPI
Shirley J Hom, PA C
- Medical Physician Assistant
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9102291
- Practice address
- 1400 S Orange Ave
Orlando, FL 32806-2134 - Phone
- (321) 843-8010
- Fax
- (321) 843-6330
- NPI assigned
- Sep 16, 2005
- Last updated
- Jul 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9102291 | FL | |
| Surgical Physician Assistant | 363AS0400X | PA9102291 | FL | |
| Medical Physician Assistant | 363AM0700X | PA9102291 | FL | Primary |
Addresses
Primary practice location
1400 S Orange Ave
Orlando, FL 32806-2134
Mailing address
1400 S Orange Ave
Orlando, FL 32806-2134
Phone (321) 843-8010
Other practice location 1
4215 Edgewater Dr
Orlando, FL 32804-2206
Phone (407) 539-2000
Other practice location 2
601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 609-0095
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E8990G | Other | FL | MEDICARE GROUP PTAN |
| 291475100 | Medicaid | FL |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22 W Underwood St
Orlando, FL 32806-1110
Phone (407) 648-3800
2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700
32 W Gore St
Orlando, FL 32806-1134
380 Rinehart Rd
Lake Mary, FL 32746-2551
Phone (407) 767-1200
52 W Underwood St
Orlando, FL 32806-1110
Phone (407) 841-5111
601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570
76 W Underwood St
Orlando, FL 32806-1110
86 W Underwood St
Orlando, FL 32806-1110
Phone (407) 896-1100
9400 Turkey Lake Rd
Orlando, FL 32819-8001
Phone (407) 354-1202
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.91 of 100
- Quality
- 61.18
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.86
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13480 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Medical Group Inc | Physician Assistant | Current | Accepting new patients |
| Orlando Health Medical Group Inc | Current | Accepting new patients | |
| Florida Hospital Medical Group Inc | Current | Accepting new patients | |
| Orlando Health Medical Group Inc | Current | Accepting new patients | |
| Southeastern Clinical Services,Inc. | Surgical | Past | Accepting new patients |
| Stephen Schreiber, MD | Past | Accepting new patients |
Locations
2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700
1400 S Orange Ave
Orlando, FL 32806
Phone (321) 841-1893
32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820
601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- shom130562@adventhealth.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba AdventHealth Medical Group
- Family Medicine Physician
- Orlando, FL
- NPI 1225034234
Physician Assistant
-
- Internal Medicine Physician
- Orlando, FL
- NPI 1669429577
-
dba Rothman Orthopaedics AdventHealth Medical Group at Minneola
- Prosthetic/Orthotic Supplier
- Minneola, FL
- NPI 1285591545
-
- Durable Medical Equipment & Medical Supplies
- Winter Park, FL
- NPI 1265019541
-
- Surgical Physician Assistant
- Orlando, FL
- NPI 1033162011
-
dba Orlando Vascular Associates
- Surgery Physician
- Winter Park, FL
- NPI 1275581589
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba AdventHealth Orlando
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
-
dba AdventHealth Orlando Outreach Laboratory
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721347200000",
"number": "1972598860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 S ORANGE AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328062134",
"telephone_number": "321-843-8010",
"fax_number": "321-843-6330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 S ORANGE AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328062134",
"telephone_number": "321-843-8010",
"fax_number": "321-843-6330"
}
],
"practiceLocations": [
{
"address_1": "4215 Edgewater Dr",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "328042206",
"country_code": "US",
"telephone_number": "407-539-2000",
"fax_number": "407-398-0050",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "601 E Rollins St",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "328031248",
"country_code": "US",
"telephone_number": "407-609-0095",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOM",
"first_name": "SHIRLEY",
"middle_name": "J",
"credential": "PA C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-16",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9102291",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": "PA9102291",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9102291",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PTAN",
"identifier": "E8990G",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "291475100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orlando, FL
- Stacy Cathleen Holton, ARNP-BC
- Emily Holuta, LMHC
- Jennifer Holycross, APRN
- Joseph Craig Holzmacher, PSY.D.
- Karen Mary Hom
- Homa Institute LLC
- Home & Lifestyle Support Services, LLC
- Home Care & Bahavior Support Inc
- Home Family Solutions LLC
- Home Health Corporation of America, Inc-Orlando (Home Health Corporation of America)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.