Individual provider Active NPI

Sean Michael Baxter, PA-C

  • Physician Assistant
  • Southold, NY
National Provider Identifier
1598200438
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020436-1 Issued in NY
Practice address
5805 Main Bayview Rd
Southold, NY 11971-4831
Phone
(707) 726-2768
NPI assigned
Jan 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 020436-1 NY Primary

Addresses

Primary practice location

5805 Main Bayview Rd
Southold, NY 11971-4831

Mailing address

855 N US Highway 17 92
Longwood, FL 32750-3167
Phone (707) 726-2768

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20200929001350 OH Practitioner - Physician Assistant 7719261965 Reassigns benefits to 1 organization
I20220715001984 FL Practitioner - Physician Assistant 7719261965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health System Sunbelt, Inc. 212 clinicians

Practice addresses (Care Compare)

11550 University Blvd
Orlando, FL 32817-2100
Phone (407) 384-0080

440 W Hwy 436
Adventhealth Centra Care Altamonte
Altamonte Springs, FL 32714-4136
Phone (407) 788-2000

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
020436-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wooster Clinic, LLC CurrentSince Aug 12, 2020 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Jul 15, 2022 Accepting new patients
Adventist Health System/Sunbelt, Inc. Physician Assistant CurrentSince Jul 15, 2022 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

2600 Westhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 200-1353

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Interoperability endpoints

  • Direct secure messaging: sbaxter645215@adventhealth.direct-ci.com

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.

Hospital & facility affiliations 2

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": "1483315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1598200438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 N US HIGHWAY 17 92",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503167",
            "telephone_number": "707-726-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 MAIN BAYVIEW RD",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119714831",
            "telephone_number": "707-726-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAXTER",
        "first_name": "SEAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-02",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020436-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southold, NY

Sources for this page

Verify at the official NPI Registry.