Organization Active NPI

Sarasota Medical Clinic PA

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Sarasota, FL
National Provider Identifier
1760415574
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
Legal business name
SARASOTA MEDICAL CLINIC PA
Practice address
5640 Marquesas Cir
Sarasota, FL 34233-3331
Phone
(941) 921-5741
Fax
(941) 927-5746
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Authorized official

Name
Ms. Avery R. Dye
Title
Billing
Phone
(941) 921-5741

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204C00000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X

Addresses

Primary practice location

5640 Marquesas Cir
Sarasota, FL 34233-3331

Mailing address

5640 Marquesas Cir
Sarasota, FL 34233-3331
Phone (941) 921-5741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041222000198 FL Part B Supplier - Clinic/Group Practice 5597723593 Receives reassigned benefits from 5 practitioners
Practice locations: Sarasota, FL

National Provider Directory

National Provider Directory

Locations

7222 S Tamiami Trl
Ste 104
Sarasota, FL 34231
Phone (941) 921-5741

5640 Marquesas Cir
Sarasota, FL 34233
Phone (941) 921-5741

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1760415574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5640 MARQUESAS CIR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342333331",
            "telephone_number": "941-921-5741",
            "fax_number": "941-927-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 MARQUESAS CIR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342333331",
            "telephone_number": "941-921-5741",
            "fax_number": "941-927-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARASOTA MEDICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "DYE",
        "authorized_official_first_name": "AVERY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "941-921-5741",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.