Individual provider Active NPI

Monika E Holder, PA

  • Medical Physician Assistant
  • Sarasota, FL
National Provider Identifier
1245524529
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9105953 Issued in FL
Practice address
5310 Clark Rd Ste 201
Sarasota, FL 34233-3229
Phone
(941) 925-3627
Fax
(866) 405-4932
NPI assigned
Jun 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9105953 FL Primary

Addresses

Primary practice location

5310 Clark Rd Ste 201
Sarasota, FL 34233-3229

Mailing address

4919 Memorial Hwy Ste 150
Tampa, FL 33634-7516
Phone (813) 333-1512

Other identifiers 1

IdentifierTypeStateIssuer
007794800MedicaidFL

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
I20110902000387 FL Practitioner - Physician Assistant 5395915136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5310 Clark Rd
Suite 201
Sarasota, FL 34233-3228

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9105953FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Brannan Consultants, PL Dermatology CurrentSince Jan 2, 2012 Accepting new patients

Locations

5310 Clark Rd
Ste 201
Sarasota, FL 34233
Phone (941) 925-3627

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mholder@dmp.emadirect.md

Organizations & group practices 2

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": "1307145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1245524529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 MEMORIAL HWY STE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336347516",
            "telephone_number": "813-333-1512",
            "fax_number": "813-333-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 CLARK RD STE 201",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342333229",
            "telephone_number": "941-925-3627",
            "fax_number": "866-405-4932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "MONIKA",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-04",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007794800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.