Organization Active NPI

Sandbay Family Practice, L.L.C.

  • General Practice Physician
  • Clearwater, FL
National Provider Identifier
1568774479
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS 10771 Issued in FL
Legal business name
SANDBAY FAMILY PRACTICE, L.L.C.
Practice address
2086 Gulf to Bay Blvd
Clearwater, FL 33765-3714
Phone
(727) 462-0100
Fax
(727) 462-0177
NPI assigned
Jul 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Anthony Ngo, D.ONPI 1033316815
Title
Ceo
Phone
(727) 462-0100

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X OS 10771 FL Primary

Addresses

Primary practice location

2086 Gulf to Bay Blvd
Clearwater, FL 33765-3714

Mailing address

2086 Gulf to Bay Blvd
Clearwater, FL 33765-3714
Phone (727) 462-0100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101026001306 FL Part B Supplier - Clinic/Group Practice 5597958280 Receives reassigned benefits from 9 practitioners
Practice locations: Clearwater, FL; Pinellas Park, FL

National Provider Directory

National Provider Directory

Locations

2086 Gulf To Bay Blvd
Clearwater, FL 33765
Phone (727) 462-0010

915 Chestnut St
Clearwater, FL 33756

7599 Park Blvd N
Pinellas Park, FL 33781
Phone (727) 462-0100

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1568774479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2086 GULF TO BAY BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653714",
            "telephone_number": "727-462-0100",
            "fax_number": "727-462-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2086 GULF TO BAY BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653714",
            "telephone_number": "727-462-0100",
            "fax_number": "727-462-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDBAY FAMILY PRACTICE, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-08",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "NGO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "727-462-0100",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS 10771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.