Individual provider Active NPI

Cassie Gruber, PA-C

  • Surgical Physician Assistant
  • Sarasota, FL
National Provider Identifier
1467937516
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
1630 S Tuttle Ave
Sarasota, FL 34239-3108
Phone
(941) 556-6900
Fax
(941) 556-6920
NPI assigned
Sep 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA9111577 FL
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

1630 S Tuttle Ave
Sarasota, FL 34239-3108

Mailing address

1827 Loma Linda St
Sarasota, FL 34239-2206
Phone (941) 544-0964

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
I20181127003275 FL Practitioner - Physician Assistant 8123362464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy White and Riggs Orthopedic AssociatesGroup PAC ID 0840185310, 36 clinicians

Practice addresses (Care Compare)

6050 Cattleridge Blvd
Sarasota, FL 34232-6014
Phone (941) 365-0655

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • HCA Florida Sarasota Doctors Hospital Hospital, Sarasota, FL, CCN 100166
  • Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA9111577FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy White & Riggs Orthopedic Associates CurrentSince Jun 20, 2022 Accepting new patients

Locations

6050 Cattleridge Blvd
Ste 201
Sarasota, FL 34232
Phone (941) 365-0655

Interoperability endpoints

  • Direct secure messaging: cgruber@kwoc1429.srs-direct.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1467937516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 LOMA LINDA ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392206",
            "telephone_number": "941-544-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 S TUTTLE AVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393108",
            "telephone_number": "941-556-6900",
            "fax_number": "941-556-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "CASSIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111577",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.