NPIMap

Individual provider Active NPI

Nicholas Sakellarios, D.O.

  • Internal Medicine Physician
  • Sarasota, FL
National Provider Identifier
1033352448
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS16406 Issued in FL
Practice address
1921 Waldemere St Ste 512
Sarasota, FL 34239-2941
Phone
(941) 917-3500
Fax
(941) 917-8556
NPI assigned
Apr 15, 2009
Last updated
Jun 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 263962 NY
Internal Medicine Physician 207R00000X OS16406 FL Primary

Addresses

Primary practice location

1921 Waldemere St Ste 512
Sarasota, FL 34239-2941

Mailing address

PO Box 863407
Orlando, FL 32886-3407
Phone (941) 917-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120718000680 NY Practitioner - Internal Medicine 3274799341
I20200720000933 FL Practitioner - Internal Medicine 3274799341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians
Mastercare Physical Therapy IncGroup PAC ID 6103073499, 51 clinicians

Practice addresses (Care Compare)

17470 Brookside Trace CT
Tampa, FL 33647-6201
Phone (813) 443-5042

1921 Waldemere St
Suite 512
Sarasota, FL 34239-2941
Phone (941) 917-3500

3982 Bee Ridge Rd
Sarasota, FL 34233-1210
Phone (941) 377-6700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS16406FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Internal Medicine CurrentSince Sep 7, 2020 Accepting new patients
Pilip Medical Care Internal Medicine PastSince Feb 9, 2019 Accepting new patients
SMH Physician Services Inc Past Accepting new patients
Optum Urgent Care, PLLC Past Accepting new patients

Locations

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

1921 Waldemere St
Ste 512
Sarasota, FL 34239
Phone (941) 917-3270

Interoperability endpoints

  • Direct secure messaging: nicholas.sakellarios@fpg.directbygreenway.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1033352448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "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": "1921 WALDEMERE ST STE 512",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392941",
            "telephone_number": "941-917-3500",
            "fax_number": "941-917-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKELLARIOS",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-15",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "263962",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS16406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.