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DR. SHIRLI SAMARA DO MBA
NPI 1588423693
Student in an Organized Health Care Education/Training Program in Orange Park, FL

Active since March 19, 2024PECOS Enrolled
2001 KINGSLEY AVE, ORANGE PARK, FL 32073(904) 639-8500 Get Directions Write a Review

NPPES record last updated: March 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Shirli Samara Do Mba NPPES

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

DR. SHIRLI SAMARA DO MBA (NPI 1588423693) is an individual student in an organized health care education/training program in Orange Park, Florida and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588423693
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. SHIRLI SAMARACredential: DO MBA
Location Address2001 KINGSLEY AVEOrange Park, FL 32073-5148
Mailing Address2001 Kingsley AveOrange Park, FL 32073-5148 · (904) 639-8500
Phone(904) 639-8500
Sole ProprietorYes
Enumeration DateMarch 19, 2024
NPPES CertifiedMarch 19, 2024
✔ NPI 1588423693 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2001 KINGSLEY AVE, Orange Park, FL 32073
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shirli Samara Do Mba is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

DR. FORREST KING M.D.
Emergency Medicine
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-8500
DIANA LYNN BRIDGES ARNP
Nurse Practitioner (Family)
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-8500
TOMAS LUKE LAMBERT MD
Student in an Organized Health Care Education/Training Program
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-2000
CHRISTY GIEGER PA-C
Physician Assistant (Surgical)
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 314-7733
DR. BENJAMIN ROBERT COOPER DO
Student in an Organized Health Care Education/Training Program
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-8500
CHIRAAG ASHOKKUMAR MD
Student in an Organized Health Care Education/Training Program
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-2005
DR. ALEXANDER NATHANIEL HOWELL DO
Dermatology
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-2000
KUNAL PATEL DO
Student in an Organized Health Care Education/Training Program
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-2005

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 Shirli Samara's NPI number?

The NPI number for Shirli Samara is 1588423693. It was assigned to this individual provider in the NPPES registry on March 19, 2024.

Where is Shirli Samara located?

Shirli Samara practices at 2001 Kingsley Ave, Orange Park, FL 32073. The listed phone number is (904) 639-8500.

What is Shirli Samara's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Shirli Samara enrolled in Medicare?

Yes. Shirli Samara is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shirli Samara was last updated on March 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.