Individual provider Active NPI

Spencer Bezalel, MD

  • MOHS-Micrographic Surgery Physician
  • Sarasota, FL
National Provider Identifier
1477932341
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
ME150980 Issued in FL
Practice address
2001 Siesta Dr
Sarasota, FL 34239-5200
Phone
(813) 321-1786
Fax
(813) 321-1787
NPI assigned
May 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME150980 FL
MOHS-Micrographic Surgery Physician 207ND0101X MD.40572 AL
Dermatology Physician 207N00000X MD.40572 AL
Procedural Dermatology Physician 207NS0135X MD.40572 AL
MOHS-Micrographic Surgery Physician 207ND0101X ME150980 FL Primary

Addresses

Primary practice location

2001 Siesta Dr
Sarasota, FL 34239-5200

Mailing address

4651 Van Dyke Rd
Lutz, FL 33558-4880
Phone (813) 321-1786

Other practice location 1

500 Vonderburg Dr Ste 115W
Brandon, FL 33511-5969
Phone (813) 321-1786

Other practice location 2

5200 Seminole Blvd
St Petersburg, FL 33708-3356
Phone (813) 321-1786

Other practice location 3

14095 Cortez Blvd
Brooksville, FL 34613-5794
Phone (813) 321-1786

Other practice location 4

500 Vonderburg Dr Ste 202E
Brandon, FL 33511-5999
Phone (813) 321-1786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200611003099 AL Practitioner - Dermatology 7719295351 Reassigns benefits to 1 organization
I20210604000110 FL Practitioner - Dermatology 7719295351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of South Florida College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suncoast Skin SolutionsGroup PAC ID 7416018221, 102 clinicians

Practice addresses (Care Compare)

2001 Siesta Dr
Suite 201
Sarasota, FL 34239-5200
Phone (813) 321-1786

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision193
Removal of tissue1-10
Removal of skin lesions88
Removal of skin cancer941
Removal of nail tissue1-10
Skin biopsy40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.40572ALMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Skin Solutions Dermatology CurrentSince Jun 1, 2021 Accepting new patients
Aqua Dermatology of Alabama PC Dermatology CurrentSince Jul 1, 2020 Accepting new patients
Cutaneous Oncology & Surgery Center, LLC Past Accepting new patients
Douglas K Pierce MD PA Procedural Dermatology PastSince Jun 1, 2021 Accepting new patients

Locations

7300 Halcyon Summit Dr
Montgomery, AL 36117

1940 Stonegate Dr
Ste 130
Vestavia Hls, AL 35242
Phone (205) 451-9481

1940 Stonegate Dr
Ste 140
Vestavia Hls, AL 35242
Phone (205) 968-3919

500 Vonderburg Dr
Ste 115W
Brandon, FL 33511
Phone (813) 535-6212

500 Vonderburg Dr
Ste 202E
Brandon, FL 33511

14095 Cortez Blvd
Brooksville, FL 34613
Phone (352) 336-1840

2467 Enterprise Rd
Ste A
Clearwater, FL 33763
Phone (727) 350-2949

525 N Dacie Pt
Lecanto, FL 34461
Phone (352) 746-2200

608 S 9th St
Ste C
Leesburg, FL 34748
Phone (352) 787-4532

4651 Van Dyke Rd
Lutz, FL 33558

9401 SW Highway 200
Ste 1001
Ocala, FL 34481

2001 Siesta Dr
Ste 201
Sarasota, FL 34239
Phone (941) 365-5582

11200 Seminole Blvd
Ste 205
Seminole, FL 33778
Phone (727) 820-1786

5200 Seminole Blvd
St Petersburg, FL 33708
Phone (727) 392-3376

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: spencer.bezalel@suncoastskin.emadirect.md

Organizations & group practices 4

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": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1477932341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584880",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SIESTA DR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342395200",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Vonderburg Dr Ste 115W",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115969",
            "country_code": "US",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5200 Seminole Blvd",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337083356",
            "country_code": "US",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14095 Cortez Blvd",
            "address_purpose": "LOCATION",
            "city": "Brooksville",
            "state": "FL",
            "postal_code": "346135794",
            "country_code": "US",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Vonderburg Dr Ste 202E",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115999",
            "country_code": "US",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEZALEL",
        "first_name": "SPENCER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME150980",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AL",
            "license": "MD.40572",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "MD.40572",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AL",
            "license": "MD.40572",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME150980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.