Organization Active NPI

Collective Aesthetics & Regenerative Medicine PLLC

  • Emergency Medicine Physician
  • Palm City, FL
National Provider Identifier
1275411480
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
COLLECTIVE AESTHETICS & REGENERATIVE MEDICINE PLLC
Practice address
3381 SW Mapp Rd
Palm City, FL 34990-3302
Phone
(772) 607-8200
Fax
(772) 264-9633
NPI assigned
Aug 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Authorized official

Name
Alexandra Snyder, DONPI 1356874788
Title
Owner
Phone
(772) 607-8200

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

3381 SW Mapp Rd
Palm City, FL 34990-3302

Mailing address

409 SW Ashby LN
Palm City, FL 34990-1760
Phone (772) 607-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250927000451 FL Part B Supplier - Clinic/Group Practice 4486159522 Receives reassigned benefits from 2 practitioners
Practice locations: Palm City, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2328900The Collective Aesthetics & Regenerative3381 SW Mapp Rd, Palm City, FL 34990Certificate of waiverAug 18, 2027

National Provider Directory

National Provider Directory

Locations

3381 SW Mapp Rd
Palm City, FL 34990
Phone (772) 607-8200

Practitioners & affiliated clinicians

Practitioners 2

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": "1756080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756080000000",
    "number": "1275411480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 SW ASHBY LN",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349901760",
            "telephone_number": "772-607-8200",
            "fax_number": "772-264-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3381 SW MAPP RD",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349903302",
            "telephone_number": "772-607-8200",
            "fax_number": "772-264-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLECTIVE AESTHETICS & REGENERATIVE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-607-8200",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.

Verify at the official NPI Registry.