Individual provider Active NPI

Sherrie Bast

  • Clinical Social Worker
  • Leesburg, FL
National Provider Identifier
1780208454
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW17286 Issued in FL
Practice address
117 S Lake Dr
Leesburg, FL 34788-2680
Phone
(352) 874-1610
NPI assigned
May 29, 2020
Last updated
May 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW17286 FL Primary

Addresses

Primary practice location

117 S Lake Dr
Leesburg, FL 34788-2680

Mailing address

117 S Lake Dr
Leesburg, FL 34788-2680
Phone (352) 874-1610

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201016002444 FL Practitioner - Clinical Social Worker 5890115620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sailor Health Medical PAGroup PAC ID 4486182342, 301 clinicians

Practice addresses (Care Compare)

201 S Biscayne Blvd
Suite 2867
Miami, FL 33131-4330
Phone (786) 269-0333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ultima Rehab-FL LLC CurrentSince Oct 14, 2020 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Sailor Health Medical PA Clinical CurrentSince Apr 1, 2025 Accepting new patients

Locations

201 S Biscayne Blvd
Ste 2867
Miami, FL 33131
Phone (786) 269-0333

333 SE 2nd Ave
Ste 2000
Miami, FL 33131
Phone (201) 581-3411

390 Pondella Rd
Ste 9
North Ft Myers, FL 33903
Phone (239) 652-0260

Interoperability endpoints

  • Direct secure messaging: sherriebast@tdh.allscriptsdirect.net

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": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1780208454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S LAKE DR",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347882680",
            "telephone_number": "352-874-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S LAKE DR",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347882680",
            "telephone_number": "352-874-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAST",
        "first_name": "SHERRIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.