Individual provider Active NPI

Sandra Lynn Snyder, P.A.

  • Medical Physician Assistant
  • Tampa, FL
National Provider Identifier
1053300723
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9101056 Issued in FL
Practice address
4200 N Armenia Ave
Suite 1
Tampa, FL 33607-6438
Phone
(813) 877-4811
Fax
(813) 872-8978
NPI assigned
Oct 17, 2005
Last updated
Jul 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9101056 FL Primary

Addresses

Primary practice location

4200 N Armenia Ave
Suite 1
Tampa, FL 33607-6438

Mailing address

4200 N Armenia Ave
Suite 1
Tampa, FL 33607-6438
Phone (813) 877-4811

Other identifiers 1

IdentifierTypeStateIssuer
U0777YOtherFLPTAN

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
I20080226000310 FL Practitioner - Physician Assistant 0648354951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Group of Florida, P.a.Group PAC ID 1153367107, 54 clinicians

Practice addresses (Care Compare)

13732 17TH St
Dade City, FL 33525-4608
Phone (800) 809-4811

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

2727 W Dr Martin Luther King Jr Blvd
Suite 630
Tampa, FL 33607-6399
Phone (813) 877-4811

720 Cortaro Dr
Sun City Center, FL 33573-6811
Phone (813) 877-4811

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher G. Nelson, M.D., P.a. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ssnyder@dcm.emadirect.md

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1053300723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 N ARMENIA AVE",
            "address_2": "SUITE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076438",
            "telephone_number": "813-877-4811",
            "fax_number": "813-872-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 N ARMENIA AVE",
            "address_2": "SUITE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076438",
            "telephone_number": "813-877-4811",
            "fax_number": "813-872-8978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "SANDRA",
        "middle_name": "LYNN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "U0777Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.