Individual provider Active NPI

Enrico V Vintayen, MD

  • Neurology Physician
  • Sarasota, FL
National Provider Identifier
1003103706
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME126337 Issued in FL
Practice address
1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone
(941) 917-4896
Fax
(941) 917-6884
NPI assigned
Jun 30, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X D0073954 MD
Neurology Physician 2084N0400X 25MA09271100 NJ
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X ME126337 FL Primary

Addresses

Primary practice location

1700 S Tamiami TRL
Sarasota, FL 34239-3509

Mailing address

PO Box 947407
Atlanta, GA 30394-7407
Phone (941) 917-2600

Other practice location 1

517 Tamiami Trl
Punta Gorda, FL 33950-5520
Phone (941) 629-1181

Other identifiers 2

IdentifierTypeStateIssuer
016725100MedicaidFL
PH139OtherFLMC

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
I20160406000999 FL Practitioner - Neurology 7719129840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0073954MDMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Neurology CurrentSince Aug 20, 2022 Accepting new patients
Hudson Neurosciences, PC Neurology Past Accepting new patients

Locations

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

Networks

  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network
  • FL HMO C-SNP
  • AL HMO
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • AL HMO D-SNP
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e

Organizations & group practices 2

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": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1003103706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S TAMIAMI TRL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393509",
            "telephone_number": "941-917-4896",
            "fax_number": "941-917-6884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "517 Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Punta Gorda",
            "state": "FL",
            "postal_code": "339505520",
            "country_code": "US",
            "telephone_number": "941-629-1181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINTAYEN",
        "first_name": "ENRICO",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "MD",
            "license": "D0073954",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA09271100",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME126337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016725100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC",
            "identifier": "PH139",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.