Active NPI
Sean Michael Gast, PA-C
- Physician Assistant
- Bradenton, FL
National Provider Identifier
1063172062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9115401
- Practice address
- 5860 Ranch Lake Blvd Ste 200
Bradenton, FL 34202-3719 - Phone
- (941) 388-8997
- NPI assigned
- Dec 19, 2021
- Last updated
- Dec 19, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9115401 | FL | Primary |
Addresses
Primary practice location
5860 Ranch Lake Blvd Ste 200
Bradenton, FL 34202-3719
Mailing address
5860 Ranch Lake Blvd Ste 200
Bradenton, FL 34202-3719
Phone (941) 388-8997
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 4, 2025 through Feb 4, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9115401 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639872000000",
"number": "1063172062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5860 RANCH LAKE BLVD STE 200",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342023719",
"telephone_number": "941-388-8997",
"fax_number": "941-306-5876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5860 RANCH LAKE BLVD STE 200",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342023719",
"telephone_number": "941-388-8997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAST",
"first_name": "SEAN",
"middle_name": "MICHAEL",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-19",
"last_updated": "2021-12-19",
"certification_date": "2021-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9115401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.