Individual provider Active NPI

Alexander Nicholas Petreas, PA-C

  • Medical Physician Assistant
  • Sarasota, FL
National Provider Identifier
1205951522
Registry record updated Jan 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 9103356 Issued in FL
Practice address
2830 Bee Ridge Rd
Sarasota, FL 34239-7115
Phone
(941) 927-1234
Fax
(941) 921-0043
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9103356 FL
Medical Physician Assistant 363AM0700X PA 9103356 FL Primary

Addresses

Primary practice location

2830 Bee Ridge Rd
Sarasota, FL 34239-7115

Mailing address

655 East Pointe Court
Sarasota, FL 34232
Phone (941) 371-3749

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051108000356 FL Practitioner - Physician Assistant 3678591609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9103356FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Good Business LLC CurrentSince Jan 1, 2025 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Jan 10, 2015 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Jan 10, 2015 Accepting new patients
U.S. Healthworks Medical Group of Florida, Inc. Past Accepting new patients
Constantine G. Marousis MD PA Past Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

2830 Bee Ridge Rd
Sarasota, FL 34239
Phone (941) 342-6505

808 E Venice Ave
Venice, FL 34285
Phone (941) 412-3800

Networks

  • Freedom Health HMO Network

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737158400000",
    "number": "1205951522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 EAST POINTE COURT",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34232",
            "telephone_number": "941-371-3749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 BEE RIDGE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342397115",
            "telephone_number": "941-927-1234",
            "fax_number": "941-921-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREAS",
        "first_name": "ALEXANDER",
        "middle_name": "NICHOLAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103356",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9103356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.