ABUBAKER SHADOUL MOHAMED FARAH M.D.
NPI 1104564525
Internal Medicine in Tavares, FL

Q: What is Abubaker Farah's NPI number?

The NPI number for Abubaker Farah is 1104564525. It was assigned to this individual provider in the NPPES registry on May 25, 2022.

Q: What is Abubaker Farah's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Abubaker Farah was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since May 25, 2022PECOS EnrolledAccepts Medicare Assignment

1000 WATERMAN WAY, TAVARES, FL 32778(352) 742-3578(352) 742-3581 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 18, 2025, Jan 26, 2023, May 25, 2022 (3 updates tracked since 2022).

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About Abubaker Shadoul Mohamed Farah M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ABUBAKER SHADOUL MOHAMED FARAH M.D. (NPI 1104564525) is an individual internal medicine provider in Tavares, Florida, licensed in Florida (ME171818) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Waterman, and maintains a secondary practice location in Detroit.

NPPES Registry Identity

NPI1104564525

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameABUBAKER SHADOUL MOHAMED FARAHCredential: M.D.

Location Address1000 WATERMAN WAYTavares, FL 32778-5266

Mailing Address770 W Granada Blvd Ste 101Ormond Beach, FL 32174-5179 · (386) 231-4746 · Fax (386) 368-8927

Phone(352) 742-3578

Fax(352) 742-3581

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateMay 25, 2022

Last NPPES UpdateAugust 25, 20253 updates tracked since enumeration

NPPES CertifiedAugust 25, 2025

✔ NPI 1104564525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in FL · ME171818

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1000 WATERMAN WAY, Tavares, FL 32778

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Secondary Practice Location 1

Location 14201 St. Antoine, University Health Center, Suite 6ADetroit, MI 48201 · Phone (313) 745-4627

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

Abubaker Shadoul Mohamed Farah M.d. 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.

PECOS PAC ID5496269946

PECOS Enrollment IDI20250708002578

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Adventhealth Waterman

Acute Care Hospitals · Tavares, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number100057

Location1000 Waterman WayTavares, FL 32778 · Lake County

Birthing friendly

Uf Health Leesburg Hospital

Acute Care Hospitals · Leesburg, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100084

Location600 E Dixie AveLeesburg, FL 34748 · Lake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32778 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

ALEEN JOY MCGOWAN

Nurse Anesthetist, Certified Registered