Individual provider Active NPI

Robert John Siragusa, MD

  • Dermatology Physician
  • Panama City, FL
National Provider Identifier
1255320545
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME 23244 Issued in FL
Practice address
1900 Harrison Ave
Panama City, FL 32405-4542
Phone
(850) 769-1668
Fax
(850) 785-2123
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME 23244 FL Primary

Addresses

Primary practice location

1900 Harrison Ave
Panama City, FL 32405-4542

Mailing address

1900 Harrison Ave
Panama City, FL 32405-4542
Phone (850) 769-1668

Other identifiers 1

IdentifierTypeStateIssuer
99500OtherBCBS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100920000190 FL Practitioner - Dermatology 1153446786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
New York Medical College, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of Bay County PAGroup PAC ID 5799800322, 11 clinicians

Practice addresses (Care Compare)

1900 Harrison Ave
Panama City, FL 32405-4542
Phone (850) 769-1668

Merit-based Incentive Payment System (MIPS)

Final score
97.48 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
91.61

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision15
Removal of skin lesions1305
Removal or shaving of skin growth114
Skin biopsy782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 23244FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Bay County, P.a. Dermatology CurrentSince Nov 1, 1974 Accepting new patients
Dermatology Associates of Bay County, P.a. Dermatology PastSince Oct 12, 2025 Accepting new patients
Dermatology Associates of Bay County, P.a. Dermatology PastSince Dec 14, 2025 Accepting new patients

Locations

877 3rd St
Ste 3
Chipley, FL 32428
Phone (850) 638-0505

1900 Harrison Ave
Panama City, FL 32405
Phone (850) 769-7546

100 N Richard Jackson Blvd
Ste 140
Panama City Beach, FL 32407
Phone (850) 769-7546

12216 Panama City Beach Pkwy
Ste D
Panama City Beach, FL 32407
Phone (850) 655-7090

Organizations & group practices 3

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1255320545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-769-1668",
            "fax_number": "850-785-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-769-1668",
            "fax_number": "850-785-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRAGUSA",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME 23244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "99500",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.