Active NPI
Neil Sandhu PA
- Dermatology Physician
- Orange City, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- NEIL SANDHU PA
- Practice address
- 258 Treemonte Dr Ste 258
Orange City, FL 32763-7945 - Phone
- (386) 628-3376
- NPI assigned
- Jul 8, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Neil Sandhu, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary | ||
| MOHS-Micrographic Surgery Physician | 207ND0101X | |||
| Dermatopathology Physician | 207ND0900X | |||
| Procedural Dermatology Physician | 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
- Aspire Dermatology And Aesthetics
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2242820 | Annexus Dermatology & Aesthetics | Compliance | Apr 6, 2028 |
National Provider Directory
National Provider DirectoryLocations
860 Peachwood Dr
Deland, FL 32720
Phone (386) 628-3376
2300 Maitland Center Pkwy
#A
Maitland, FL 32751
Phone (386) 628-3376
2723 SE Maricamp Rd
Ocala, FL 34471
Phone (352) 732-5211
258 Treemonte Dr
Orange City, FL 32763
Phone (386) 628-3376
1656 S Volusia Ave
#B
Orange City, FL 32763
1131 S Orange Ave
Orlando, FL 32806
Phone (407) 237-6333
3875 S Nova Rd
Port Orange, FL 32127
Phone (386) 322-9244
Practitioners & affiliated clinicians
Practitioners 16
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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.