DR. SAMIR SHAH DO
NPI 1104563790
Internal Medicine in Jacksonville, FL
About Dr. Samir Shah Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. SAMIR SHAH DO (NPI 1104563790) is an individual internal medicine provider in Jacksonville, Florida, licensed in Florida (S000-791-95-288-0) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS, is affiliated with Hca Florida Memorial Hospital, and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Samir Shah Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Hca Florida Memorial Hospital
Acute Care Hospitals · Jacksonville, FLPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
JACKSONVILLE, FL 32216
JACKSONVILLE, FL 32216
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Samir Shah's NPI number?
The NPI number for Samir Shah is 1104563790. It was assigned to this individual provider in the NPPES registry on May 16, 2022.
Where is Samir Shah located?
Samir Shah practices at 3625 University Blvd S, Jacksonville, FL 32216. The listed phone number is (904) 702-6111.
What is Samir Shah's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Samir Shah enrolled in Medicare?
Yes. Samir Shah is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Samir Shah affiliated with any hospitals?
According to CMS data, Samir Shah is affiliated with Hca Florida Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Samir Shah was last updated on January 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Samir Shah, DO · NPI 1104563790
Internal Medicine physician in Jacksonville, Florida. Individual provider, active in the CMS NPPES registry since May 16, 2022.
## Identity
- **NPI:** 1104563790 (Entity type: Individual)
- **Enumerated:** May 16, 2022
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** S000-791-95-288-0 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 3625 UNIVERSITY BLVD S, Jacksonville, FL 32216-4207
- **Phone:** (904) 702-6111
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** January 28, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1104563790) · Data from the CMS NPPES public registry.