Individual provider Active NPI

Sadelyn De Los Santos

  • Physician Assistant
  • Boca Raton, FL
National Provider Identifier
1629608047
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9112856 Issued in FL
Practice address
1200 N Federal Hwy Ste 100
Boca Raton, FL 33432-2844
Phone
(561) 266-0190
NPI assigned
Jan 24, 2020
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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 9112856 FL Primary

Addresses

Primary practice location

1200 N Federal Hwy Ste 100
Boca Raton, FL 33432-2844

Mailing address

251 N 71St Ter
Hollywood, FL 33024-7364
Phone (917) 215-4270

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
I20200505000843 FL Practitioner - Physician Assistant 6204267396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.13 of 100Reported as group
Quality
61.92
Improvement activities
40
Cost
64.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9112856FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: sadelyndelossantos@cas.directglo.com

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": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1629608047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 N 71ST TER",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330247364",
            "telephone_number": "917-215-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N FEDERAL HWY STE 100",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334322844",
            "telephone_number": "561-266-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LOS SANTOS",
        "first_name": "SADELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9112856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.