Michelle Lundeen Pennie, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME108521 Issued in FL

Practice address

900 Pine St
Ste 122-123
Englewood, FL 34223-4418

Phone

(941) 474-8811

Fax

(941) 473-0058

NPI assigned

Jan 29, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Dermatology

Education

Emory University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bliss Dermatology LLCGroup PAC ID 9335594316, 5 clinicians

Suncoast Skin SolutionsGroup PAC ID 7416018221, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aveanna Home Health Home health agency, Sarasota, FL, CCN 108480
• Haven Home Health Care Home health agency, Venice, FL, CCN 687116

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Bliss Dermatology, LLC

  • MOHS-Micrographic Surgery Physician
  • Venice, FL
  • NPI 1689361644
  Medicare reassignment Care Compare group NPD Authorized official
• Suncoast Skin Solutions

  • Dermatology Physician
  • Lutz, FL
  • NPI 1487827416
  Medicare reassignment Care Compare group NPD
• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD
• Douglas K Pierce MD PA

  • Procedural Dermatology Physician
  • Largo, FL
  • NPI 1053515379
  NPD (past)
• Orbital and Oculo Facial Consultants, P.a.

  • Plastic and Reconstructive Surgery Physician
  • Sarasota, FL
  • NPI 1619286267
  NPD (past)
• Orbital and Oculo Facial Consultants, PA

  • Plastic and Reconstructive Surgery Physician
  • Sarasota, FL
  • NPI 1407057805
  NPD (past)

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

• Doctor'S Choice Home Care, LLC

  • Home Health Agency
  • Sarasota, FL
  • NPI 1205051497
  Care Compare affiliation
• MHC Area 8, LLC

  • Home Health Agency
  • Venice, FL
  • NPI 1518429166
  Care Compare affiliation

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356134400000",
    "number": "1497932784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PINE ST",
            "address_2": "STE 123",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234418",
            "telephone_number": "941-474-8811",
            "fax_number": "941-473-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PINE ST",
            "address_2": "STE 122-123",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234418",
            "telephone_number": "941-474-8811",
            "fax_number": "941-473-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNIE",
        "first_name": "MICHELLE",
        "middle_name": "LUNDEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2012-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "002099",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2010011561",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME108521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Peace
• Samantha Pease, RBT
• Pedro F Casanova MD PA
• Kathryn Pelosi
• Sonja Pemberton
• Rhoniel Perdigon, MD
• Peretz Chiropractic Center PA
• Julianne Peretz, DC
• Marianne T Perri
• Kenneth W. Pfahler, M.D.

• Dermatology Physician in Englewood, FL
• Providers in Englewood, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.