Individual provider Active NPI

Troy A Wubbena, PA-C, PHD

  • Medical Physician Assistant
  • Sarasota, FL
National Provider Identifier
1487802054
Registry record updated Sep 8, 2008
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Jun 20, 2011.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9104389 Issued in FL
Practice address
8451 Shade Ave
Ste 108
Sarasota, FL 34243-2878
Phone
(941) 360-1030
Fax
(941) 360-1202
NPI assigned
Sep 8, 2008
Last updated
Sep 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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 PA9104389 FL Primary

Addresses

Primary practice location

8451 Shade Ave
Ste 108
Sarasota, FL 34243-2878

Mailing address

8451 Shade Ave
Ste 108
Sarasota, FL 34243-2878
Phone (941) 360-1030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PA9104389FLMDMedical Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1487802054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8451 SHADE AVE",
            "address_2": "STE 108",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432878",
            "telephone_number": "941-360-1030",
            "fax_number": "941-360-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8451 SHADE AVE",
            "address_2": "STE 108",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432878",
            "telephone_number": "941-360-1030",
            "fax_number": "941-360-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUBBENA",
        "first_name": "TROY",
        "middle_name": "A",
        "credential": "PA-C, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.