Individual provider Active NPI

Justina Sanders

  • Medical Physician Assistant
  • Stuart, FL
National Provider Identifier
1689915167
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9107807 Issued in FL
Practice address
111 SE Osceola St
Stuart, FL 34994-2114
Phone
(866) 724-6807
NPI assigned
Mar 8, 2013
Last updated
Feb 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1104320 GA
Medical Physician Assistant 363AM0700X PA9107807 FL Primary

Addresses

Primary practice location

111 SE Osceola St
Stuart, FL 34994-2114

Mailing address

8136 SE Windjammer Way
Hobe Sound, FL 33455-3903

Other practice location 1

1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 435-6633

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
I20240926003316 FL Practitioner - Physician Assistant 7911438205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Anesthesia Associates LLCGroup PAC ID 4183619828, 47 clinicians

Practice addresses (Care Compare)

111 SE Osceola St
Suite 100
Stuart, FL 34994-2114
Phone (867) 724-6807

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9107807FLMDMedical Physician Assistant
1104320GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Surgery and Endoscopy Centers LLC CurrentSince Jul 20, 2024 Accepting new patients

Locations

208 NE 19th Dr
Okeechobee, FL 34972
Phone (863) 763-6431

4510 Donald Ross Rd
Palm Beach Gardens, FL 33418
Phone (910) 691-1853

10244 S US Highway 1
Port St Lucie, FL 34952
Phone (954) 223-5483

2300 SE Veterans Memorial Pkwy
Port St Lucie, FL 34952

111 SE Osceola St
Stuart, FL 34994
Phone (772) 242-7720

111 SE Osceola St
Ste 100
Stuart, FL 34994
Phone (866) 228-7676

325 Avenue B NW
Winter Haven, FL 33881
Phone (800) 364-9216

Interoperability endpoints

  • Direct secure messaging: justina.sanders.1@30104.direct.athenahealth.com

Organizations & group practices 2

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": "1362700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1689915167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8136 SE WINDJAMMER WAY",
            "city": "HOBE SOUND",
            "state": "FL",
            "postal_code": "334553903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SE OSCEOLA ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942114",
            "telephone_number": "866-724-6807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1061 Harmon Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Stewart",
            "state": "GA",
            "postal_code": "313145641",
            "country_code": "US",
            "telephone_number": "912-435-6633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JUSTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-08",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "1104320",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9107807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.