University Park Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME83476 Issued in FL

Legal business name

UNIVERSITY PARK DERMATOLOGY PLLC

Practice address

8451 Shade Ave
Suite 205
Sarasota, FL 34243-2878

Phone

(941) 360-2477

Fax

(941) 360-2577

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

David Sax, MDNPI 1902808462

Title

Owner

Phone

(941) 360-2477

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David S. Sax, M.D.

  • Dermatology Physician
  • Sarasota, FL
  • NPI 1902808462
  Medicare reassignment Care Compare group NPD Authorized official
• Heidi Kristina Anderson, M.D.

  • Dermatology Physician
  • Sarasota, FL
  • NPI 1386687077
  Medicare reassignment Care Compare group NPD
• Leah Soleil Cohen

  • Dermatology Physician
  • Sarasota, FL
  • NPI 1508494972
  Medicare reassignment Care Compare group NPD
• Carlee Rae Lapensee, ARNP

  • Family Nurse Practitioner
  • Sarasota, FL
  • NPI 1447572862
  Medicare reassignment Care Compare group NPD
• Jesse Lebaron, MPAS, PA-C

  • Medical Physician Assistant
  • Sarasota, FL
  • NPI 1851879217
  Medicare reassignment Care Compare group
• Ainsley Campbell Sorenson, PA-C

  • Physician Assistant
  • Lakewood Ranch, FL
  • NPI 1588473755
  Medicare reassignment Care Compare group
• Megan Elizabeth Canevari, APRN

  • Nurse Practitioner
  • Sarasota, FL
  • NPI 1023944816
  NPD
• Victoria Gladden Rain, PA-C

  • Physician Assistant
  • Kailua Kona, HI
  • NPI 1609645191
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1043221997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8451 SHADE AVE",
            "address_2": "SUITE 205",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432878",
            "telephone_number": "941-360-2477",
            "fax_number": "941-360-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8451 SHADE AVE",
            "address_2": "SUITE 205",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432878",
            "telephone_number": "941-360-2477",
            "fax_number": "941-360-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PARK DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "SAX",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-360-2477",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME83476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BC NUMBER",
            "identifier": "06331",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• University Pediatrics
• James E Updyke, PA
• Amy Upholz, AP

• Dermatology Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.