Active NPI
Michael Adam Pawlus, DDS MS
- Periodontics
- Sarasota, FL
National Provider Identifier
1134344963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN15608
- Practice address
- 2477 Stickney PT Rd
#100A
Sarasota, FL 34231 - Phone
- (941) 923-2288
- Fax
- (941) 922-0562
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN15608 | FL | Primary |
Addresses
Primary practice location
2477 Stickney PT Rd
#100A
Sarasota, FL 34231
Mailing address
2477 Stickney PT Rd
#100A
Sarasota, FL 34231
Phone (941) 923-2288
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 17, 2015 through Nov 17, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN15608 | FL | MD | Periodontist |
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": "1183852800000",
"number": "1134344963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2477 STICKNEY PT RD",
"address_2": "#100A",
"city": "SARASOTA",
"state": "FL",
"postal_code": "34231",
"telephone_number": "941-923-2288",
"fax_number": "941-922-0562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2477 STICKNEY PT RD",
"address_2": "#100A",
"city": "SARASOTA",
"state": "FL",
"postal_code": "34231",
"telephone_number": "941-923-2288",
"fax_number": "941-922-0562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAWLUS",
"first_name": "MICHAEL",
"middle_name": "ADAM",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN15608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.