Individual provider Active NPI

Sina Kasraeian, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Saint Johns, FL
National Provider Identifier
1083839930
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
ME96184 Issued in FL
Practice address
300 Saint Elizabeth Way Ste 210
Saint Johns, FL 32259-1153
Phone
(904) 634-0640
Fax
(904) 634-0203
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A94268 CA
Orthopaedic Surgery Physician 207X00000X ME96184 FL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X ME96184 FL Primary

Addresses

Primary practice location

300 Saint Elizabeth Way Ste 210
Saint Johns, FL 32259-1153

Mailing address

6800 Southpoint Pkwy Ste 300
Jacksonville, FL 32216-8203
Phone (904) 634-0640

Other practice location 1

216 Southpark Cir E Ste 216
St Augustine, FL 32086-5135
Phone (904) 634-0640

Other practice location 2

15255 Max Legget Pkwy Ste 5300
Jacksonville, FL 32218-7274
Phone (904) 634-0640

Other practice location 3

10475 Centurion Pkwy N Ste 220
Jacksonville, FL 32256-5004
Phone (904) 634-0640

Other practice location 4

351 San Juan Dr
Ponte Vedra Beach, FL 32082-1819
Phone (310) 383-5603

Other practice location 5

4268 Oldfield Crossing Dr Ste 201
Jacksonville, FL 32223-8800
Phone (904) 634-0640

Other practice location 6

3055 County Road 210 W Ste 110
St Johns, FL 32259-7001
Phone (904) 634-0640

Other practice location 7

2 Shircliff Way Ste 605
Jacksonville, FL 32204-4762
Phone (904) 634-0640

Other practice location 8

4565 US Highway 17 Ste 200
Fleming Island, FL 32003-4823
Phone (904) 634-0640

Other practice location 9

1690 US Highway 1 S Ste F
St Augustine, FL 32084-6024
Phone (904) 634-0640

Other practice location 10

22 Ponte Vedra Cir
Ponte Vedra, FL 32082-1314
Phone (904) 634-0640

Other practice location 11

2627 Riverside Ave Ste 300
Jacksonville, FL 32204-4717
Phone (904) 634-0640

Other practice location 12

45 Groover Loop Ste 201
St Augustine, FL 32086-6586
Phone (904) 634-0640

Other identifiers 2

IdentifierTypeStateIssuer
123826300MedicaidFL
149AQOtherFLBLUE CROSS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819001261 FL Practitioner - Orthopedic Surgery 1658448139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Un of California, Irvine, College of Medicine, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

2627 Riverside Ave
FL 3
Jacksonville, FL 32204-4717
Phone (904) 634-0640

PO Box
Melrose, FL 32666-1099

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.75 of 100Reported as group
Quality
88.19
Promoting interoperability
100
Improvement activities
40
Cost
80.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)26
Upper limb (arm) arthroscopy (minimally invasive joint repair)40
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Orthopedic Specialists, LLC Orthopaedic Surgery CurrentSince Feb 10, 2022 Accepting new patients
Southeast Orthopedic Specialists, LLC Orthopaedic Surgery CurrentSince Feb 10, 2022 Accepting new patients
Center for Orthopedic Research and Education, LLC Orthopaedic Surgery Past Accepting new patients

Locations

4565 US Highway 17
Ste 200
Fleming Island, FL 32003
Phone (904) 630-0640

10475 Centurion Pkwy N
Ste 220
Jacksonville, FL 32256
Phone 9046340640 ext. 1014

15255 Max Leggett Pkwy
Ste 5300
Jacksonville, FL 32218
Phone (904) 203-1386

2627 Riverside Ave
Ste 300
Jacksonville, FL 32204
Phone (904) 634-0460

2627 Riverside Ave
Fl 3
Jacksonville, FL 32204
Phone 9046340640 ext. 1014

4268 Oldfield Crossing Dr
Ste 201
Jacksonville, FL 32223
Phone (904) 630-0640

6800 Southpoint Pkwy
Ste 300
Jacksonville, FL 32216

10475 Centurion Pkwy N
Ste 200
Jacksonville, FL 32256

2 Shircliff Way
Ste 605
Jacksonville, FL 32204
Phone (904) 328-5979

216 Southpark Cir E
Ste 216
St Augustine, FL 32086
Phone (904) 634-0203

45 Groover Loop
Unit 201
St Augustine, FL 32086
Phone (904) 634-0604

1690 US Highway 1 S
Ste F
St Augustine Beach, FL 32084
Phone (904) 634-0460

300 Saint Elizabeth Way
Ste 210
St Johns, FL 32259
Phone (904) 691-9200

3055 County Road 210 W
Ste 110
St Johns, FL 32259
Phone (904) 634-0203

Interoperability endpoints

  • Direct secure messaging: skasraeian742578@direct.shands.ufl.edu
  • Direct secure messaging: sina.kasraeian.1@22724.direct.athenahealth.com

Organizations & group practices 4

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 7

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1083839930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SOUTHPOINT PKWY STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168203",
            "telephone_number": "904-634-0640",
            "fax_number": "904-209-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SAINT ELIZABETH WAY STE 210",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322591153",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 Southpark Cir E Ste 216",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865135",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15255 Max Legget Pkwy Ste 5300",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322187274",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10475 Centurion Pkwy N Ste 220",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322565004",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "351 San Juan Dr",
            "address_purpose": "LOCATION",
            "city": "Ponte Vedra Beach",
            "state": "FL",
            "postal_code": "320821819",
            "country_code": "US",
            "telephone_number": "310-383-5603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4268 Oldfield Crossing Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322238800",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3055 County Road 210 W Ste 110",
            "address_purpose": "LOCATION",
            "city": "St Johns",
            "state": "FL",
            "postal_code": "322597001",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Shircliff Way Ste 605",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044762",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4565 US Highway 17 Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320034823",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1690 US Highway 1 S Ste F",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320846024",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 Ponte Vedra Cir",
            "address_purpose": "LOCATION",
            "city": "Ponte Vedra",
            "state": "FL",
            "postal_code": "320821314",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2627 Riverside Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044717",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45 Groover Loop Ste 201",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320866586",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASRAEIAN",
        "first_name": "SINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A94268",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME96184",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME96184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123826300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "149AQ",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, FL

Sources for this page

Verify at the official NPI Registry.