Individual provider Active NPI

Alexis Taqwan Sockwell, PA-C

  • Surgical Physician Assistant
  • Sarasota, FL
National Provider Identifier
1023092913
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9101772 Issued in FL
Practice address
6050 Cattleridge Blvd
Ste 201
Sarasota, FL 34232-6014
Phone
(941) 365-0655
Fax
(941) 366-8043
NPI assigned
Dec 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9101772 FL Primary

Addresses

Primary practice location

6050 Cattleridge Blvd
Ste 201
Sarasota, FL 34232-6014

Mailing address

PO Box 50922
Sarasota, FL 34232-0307
Phone (941) 914-6610

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000512 FL Practitioner - Physician Assistant 2466418595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy White and Riggs Orthopedic AssociatesGroup PAC ID 0840185310, 36 clinicians

Practice addresses (Care Compare)

6050 Cattleridge Blvd
Sarasota, FL 34232-6014
Phone (941) 365-0655

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9101772FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reshawn G LLC Surgical Current Accepting new patients
Kennedy White & Riggs Orthopedic Associates CurrentSince Feb 19, 2013 Accepting new patients
Advance Technological Radiology, PA Past Accepting new patients
Pride Emergency Physicians LLC Past Accepting new patients
GSP Surgical Assistants, Inc Surgical PastSince Oct 28, 2004 Accepting new patients
Emergency Physician Specialists Inc PastSince Feb 1, 2013 Accepting new patients

Locations

6050 Cattleridge Blvd
Ste 201
Sarasota, FL 34232
Phone (941) 365-0655

5741 Bee Ridge Rd
Ste 370
Sarasota, FL 34233
Phone (941) 365-0655

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

Organizations & group practices 7

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 1

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": "1133568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1023092913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50922",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342320307",
            "telephone_number": "941-914-6610",
            "fax_number": "941-866-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 CATTLERIDGE BLVD",
            "address_2": "STE 201",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326014",
            "telephone_number": "941-365-0655",
            "fax_number": "941-366-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOCKWELL",
        "first_name": "ALEXIS",
        "middle_name": "TAQWAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-03",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9101772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.