Individual provider Active NPI

Dana Lynn Pilz, PA-C

  • Physician Assistant
  • Bradenton, FL
National Provider Identifier
1629264676
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113423 Issued in FL
Practice address
5301 4TH Avenue Cir E
Bradenton, FL 34208-5623
Phone
(941) 761-2900
Fax
(941) 795-1400
NPI assigned
Sep 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 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 PA9113423 FL Primary

Addresses

Primary practice location

5301 4TH Avenue Cir E
Bradenton, FL 34208-5623

Mailing address

401 Interstate Blvd
Sarasota, FL 34240-8996
Phone (941) 312-5027

Other practice location 1

897 E Venice Ave Ste A
Venice, FL 34285-7061
Phone (941) 486-1404

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210324001217 FL Practitioner - Physician Assistant 6709844038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Dermatology, LLCGroup PAC ID 6002031531, 48 clinicians

Practice addresses (Care Compare)

350 S Indiana Ave
Englewood, FL 34223-3715
Phone (941) 474-8811

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9113423FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
One Hampton Medical, LLC Physician Assistant Past Accepting new patients
Riverview Cardiac Surgery PA PastSince Feb 9, 2014 Accepting new patients
Lee R Lumpkin III MD PA PastSince Mar 6, 2006 Accepting new patients
Blue Ridge Health Center Inc Past Accepting new patients
Self Regional Healthcare Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dpilz@coastalskinsurgery.emadirect.md

Organizations & group practices 7

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": "1190505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1629264676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 INTERSTATE BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342408996",
            "telephone_number": "941-312-5027",
            "fax_number": "941-554-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 4TH AVENUE CIR E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085623",
            "telephone_number": "941-761-2900",
            "fax_number": "941-795-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "897 E Venice Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342857061",
            "country_code": "US",
            "telephone_number": "941-486-1404",
            "fax_number": "941-486-4146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PILZ",
        "first_name": "DANA",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-23",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.