Sanjay Agarwal, DO
Individual provider Active NPI Dermatology Physician · Brandon, FL
NPI 1114548864 · NPPES record last updated Jun 19, 2024
Key facts
- NPI
- 1114548864
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- OS20820 (FL)
- Practice address
- 405 W Bloomingdale Ave
Brandon, FL 33511-7401 - Phone
- (813) 662-3376
- NPI assigned
- May 5, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brandon Dermatology P a
Practice addresses (Care Compare)
405 W Bloomingdale Ave
Brandon, FL 33511-7401
Phone (813) 662-3376
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 29 |
| Removal of skin lesions | 1024 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 795 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240815000456 | FL | Practitioner - Dermatology | 5991126930 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS20820 | FL | MD | Dermatology Physician |
Practice roles (1 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brandon Dermatology P a | Dermatology | Current |
Accepting new patients |
Locations
6410 N US Highway 41
Apollo Beach, FL 33572
405 W Bloomingdale Ave
Brandon, FL 33511
Phone (813) 662-3376
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EICAAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 5151014311 | MI | |
| Dermatology Physician | 207N00000X | OS20820 | FL | Yes |
Addresses
Primary practice location
405 W Bloomingdale Ave
Brandon, FL 33511-7401
Mailing address
405 W Bloomingdale Ave
Brandon, FL 33511-7401
Phone (813) 662-3376
Other providers in Brandon, FL
- Adventist Health System/Sunbelt, Inc
- Affiliated Dental Specialist
- Affirming Therapy LLC
- Michelle Afonso
- After Hours Pediatrics, Inc.
- Bolaji A Agbede
- Ageless Placements East Inc
- Joanne Zeidan Agil
- Aging Together Inc.
- Carolyn Elaine Agnew
All providers in Brandon, FL · Dermatology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.