Individual provider Active NPI

Pierre Edson Cenizario, PA-C

  • Medical Physician Assistant
  • Sarasota, FL
National Provider Identifier
1053617985
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9105715 Issued in FL
Practice address
1540 S Tamiami TRL Ste 303
Sarasota, FL 34239-2921
Phone
(941) 917-8791
Fax
(941) 917-8793
NPI assigned
Feb 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9105715 FL Primary
Medical Physician Assistant 363AM0700X 0010-02804 NC

Addresses

Primary practice location

1540 S Tamiami TRL Ste 303
Sarasota, FL 34239-2921

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
1158PAMedicaidSC
YOEJ7OtherFLBCBS
007196200MedicaidFL

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
I20121231000142 FL Practitioner - Physician Assistant 4385828227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians
Lawnwood Cardiovascular Surgery LLCGroup PAC ID 7214937598, 53 clinicians

Practice addresses (Care Compare)

1700 S Tamiami Trail
FPG Central Billing Office
Sarasota, FL 34239-3509

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

180 John F Kennedy Dr
Suite 320
Atlantis, FL 33462-6607
Phone (561) 548-4900

1921 Waldemere St
Sarasota, FL 34239-2941

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • HCA Florida JFK Hospital Hospital, Atlantis, FL, CCN 100080

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc CurrentSince Jan 7, 2013 Accepting new patients
SMH Physician Services Inc Past Accepting new patients

Locations

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

1540 S Tamiami Trl
Ste 303
Sarasota, FL 34239
Phone (941) 371-9710

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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 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": "1297296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1053617985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "SARASOTA",
            "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": "1540 S TAMIAMI TRL STE 303",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392921",
            "telephone_number": "941-917-8791",
            "fax_number": "941-917-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CENIZARIO",
        "first_name": "PIERRE",
        "middle_name": "EDSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-10",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105715",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02804",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1158PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "YOEJ7",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007196200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.