NPIMap

Individual provider Active NPI

Sarah Gemma Puccinelli, PA

  • Physician Assistant
  • Sarasota, FL
National Provider Identifier
1760519912
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111056 Issued in FL
Practice address
3830 Bee Ridge Rd Ste 200
Sarasota, FL 34233
Phone
(941) 927-5178
Fax
(941) 921-6838
NPI assigned
Feb 27, 2007
Last updated
Aug 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085002542 IL
Physician Assistant 363A00000X PA9111056 FL Primary

Addresses

Primary practice location

3830 Bee Ridge Rd Ste 200
Sarasota, FL 34233

Mailing address

PO Box 25487
Sarasota, FL 34277-2487
Phone (941) 202-5342

Other names 1

  • Sam Girolamo Puccinelli Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180921002510 FL Practitioner - Physician Assistant 4587608609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monica K Bedi MD PAGroup PAC ID 9638196769, 15 clinicians

Practice addresses (Care Compare)

3830 Bee Ridge Rd
Suite 200
Sarasota, FL 34233-1105
Phone (941) 927-5178

7915 US Hwy 301 N 107
Dermatology Associates of Sarastoa
Ellenton, FL 34222-3532
Phone (941) 927-5178

Merit-based Incentive Payment System (MIPS)

Final score
95.82 of 100Reported as group
Quality
96.78
Improvement activities
40
Cost
90.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085002542ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Specialists CurrentSince Aug 1, 2018 Accepting new patients
Monica K Bedi MD PA CurrentSince Feb 1, 2021 Accepting new patients
Florida Medical Specialists LLC CurrentSince Aug 1, 2018 Accepting new patients
Florida Medical Specialists LLC Past Accepting new patients
Dermatology and Plastic Surgery Associates, S.C. PastSince Mar 1, 2004 Accepting new patients
Best Value Healthcare LLC Past Accepting new patients
Paragon Skin & Surgery, PA Past Accepting new patients
Pinnacle Dermatology, SC Physician Assistant Past Accepting new patients

Locations

3830 Bee Ridge Rd
Ste 100
Sarasota, FL 34233
Phone (941) 921-0383

3830 Bee Ridge Rd
Ste 200
Sarasota, FL 34233
Phone (941) 927-5178

3830 Bee Ridge Rd
Ste 301
Sarasota, FL 34233
Phone (941) 923-1872

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: sarah.puccinelli.p1@direct.alegiscare.nextgenshare.com

Organizations & group practices 10

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1760519912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25487",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342772487",
            "telephone_number": "941-202-5342",
            "fax_number": "855-253-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 BEE RIDGE RD STE 200",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34233",
            "telephone_number": "941-927-5178",
            "fax_number": "941-921-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCINELLI",
        "first_name": "SARAH",
        "middle_name": "GEMMA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002542",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAM",
            "last_name": "PUCCINELLI",
            "middle_name": "GIROLAMO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.