Individual provider Active NPI

Justin Sachs

  • Dermatology Physician
  • Bradenton, FL
National Provider Identifier
1689335911
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
PA9116928 Issued in FL
Practice address
5304 4TH Avenue Cir E
Bradenton, FL 34208-5624
Phone
(941) 761-2900
NPI assigned
Jan 8, 2022
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X PA9116928 FL Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X PA9116928 FL
Dermatology Physician 207N00000X 0110008816 VA

Addresses

Primary practice location

5304 4TH Avenue Cir E
Bradenton, FL 34208-5624

Mailing address

5304 4TH Avenue Cir E
Bradenton, FL 34208-5624
Phone (941) 761-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250603001717 VA Practitioner - Physician Assistant 1658880414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chang Skin Surgery Center LLCGroup PAC ID 4385179597, 2 clinicians

Practice addresses (Care Compare)

2117 General Booth Blvd
Virginia Beach, VA 23454-5803
Phone (757) 689-8183

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110008816VAMDDermatology Physician
PA9116928FLMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Dermatology, LLC Single Specialty Past Accepting new patients
Riverview Cardiac Surgery PA Single Specialty PastSince Feb 9, 2014 Accepting new patients

Organizations & group practices 3

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": "1641600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1689335911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5304 4TH AVENUE CIR E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085624",
            "telephone_number": "941-761-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 4TH AVENUE CIR E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085624",
            "telephone_number": "941-761-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACHS",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-08",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "PA9116928",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "PA9116928",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0110008816",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.