Individual provider Active NPI

Jerette Schultz, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Sarasota, FL
National Provider Identifier
1093179798
Registry record updated Jun 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME160313 Issued in FL
Practice address
1921 Waldemere St
Sarasota, FL 34239-2943
Phone
(941) 952-4001
Fax
(941) 952-4028
NPI assigned
Apr 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Plastic and Reconstructive Surgery Physician 2086S0122X ME160313 FL Primary

Addresses

Primary practice location

1921 Waldemere St
Sarasota, FL 34239-2943

Mailing address

PO Box 947407
Atlanta, GA 30394-7407
Phone (941) 917-2600

Other practice location 1

140 Bergen St # E1620
Newark, NJ 07103-2425
Phone (850) 377-7926

Other identifiers 1

IdentifierTypeStateIssuer
118165700MedicaidFL

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
I20230614002686 FL Practitioner - Plastic and Reconstructive Surgery 1254799810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Univ of Central Florida, College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Patients First Home Care LLC Home health agency, Sarasota, FL, CCN 687176
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy43
Melanoma (skin cancer) excision23
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc CurrentSince Aug 7, 2023 Accepting new patients
SMH Physician Services Inc Past Accepting new patients

Locations

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

1921 Waldemere St
Ste 301
Sarasota, FL 34239
Phone (941) 357-1673

1921 Waldemere St
Sarasota, FL 34239
Phone (941) 914-2600

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

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jerrett.schultz@fpg.directbygreenway.com
  • Direct secure messaging: jschultz2108924@nychhc.direct-ci.com

Organizations & group practices 2

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": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686441600000",
    "number": "1093179798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "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": "1921 WALDEMERE ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392943",
            "telephone_number": "941-952-4001",
            "fax_number": "941-952-4028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Bergen St # E1620",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032425",
            "country_code": "US",
            "telephone_number": "850-377-7926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "JERETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-08",
        "last_updated": "2023-06-11",
        "certification_date": "2023-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME160313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118165700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.