NPIMap

Organization Active NPI

Neil Sandhu PA

Doing business as Annexus Dermatology & Aesthetics

  • Dermatology Physician
  • Orange City, FL
National Provider Identifier
1124646930
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NEIL SANDHU PA
Doing business as
Annexus Dermatology & Aesthetics
Aspire Dermatology And Aesthetics
Practice address
258 Treemonte Dr Ste 258
Orange City, FL 32763-7945
Phone
(386) 628-3376
NPI assigned
Jul 8, 2020
Last updated
Oct 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Authorized official

Name
Neil Sandhu, MDNPI 1134389364
Title
Owner/President
Phone
(386) 628-3376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X
Procedural Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NS0135X

Addresses

Primary practice location

258 Treemonte Dr Ste 258
Orange City, FL 32763-7945

Mailing address

258 Treemonte Dr Ste 258
Orange City, FL 32763-7945
Phone (386) 628-3376

Other names 2

  • Annexus Dermatology & Aesthetics Doing business as
  • Aspire Dermatology And Aesthetics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200728000603 FL Part B Supplier - Clinic/Group Practice 6103240833 Receives reassigned benefits from 15 practitioners
Practice locations: Poinciana, FL; Orange City, FL; Ocoee, FL; Maitland, FL; Deland, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2242820Annexus Dermatology & Aesthetics258 Treemonte Dr Suite 258, Orange City, FL 32763ComplianceApr 6, 2028

National Provider Directory

National Provider Directory

Locations

860 Peachwood Dr
Deland, FL 32720
Phone (386) 628-3376

2300 Maitland Center Pkwy
#A
Maitland, FL 32751
Phone (386) 628-3376

2300 Maitland Center Pkwy
Ste 230
Maitland, FL 32751
Phone (407) 679-6400

1656 S Volusia Ave
#B
Orange City, FL 32763

258 Treemonte Dr
Orange City, FL 32763
Phone (386) 774-2030

258 Treemonte Dr
Unit 258
Orange City, FL 32763
Phone (888) 578-3188

13690 N US Highway 441
Ste 300
The Villages, FL 32159
Phone (352) 750-0678

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1124646930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 TREEMONTE DR STE 258",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637945",
            "telephone_number": "386-628-3376",
            "fax_number": "386-877-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 TREEMONTE DR STE 258",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637945",
            "telephone_number": "386-628-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIL SANDHU PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "SANDHU",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "386-628-3376",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Annexus Dermatology & Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aspire Dermatology And Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aspire Dermatology And Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.