Sultan Mirza, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME135477 Issued in FL

Practice address

32615 US Highway 19 N Ste 1
Palm Harbor, FL 34684-3176

Phone

(813) 321-1786

Fax

(813) 321-1787

NPI assigned

May 13, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dermatology

Education

Mayo Medical School, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suncoast Skin SolutionsGroup PAC ID 7416018221, 102 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: smirza@dat1977.srs-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Suncoast Skin Solutions

  • Dermatology Physician
  • Lutz, FL
  • NPI 1487827416
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422
  Medicare reassignment
• Douglas K Pierce MD PA

  • Procedural Dermatology Physician
  • Largo, FL
  • NPI 1053515379
  NPD (past)

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1790196699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584880",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32615 US HIGHWAY 19 N STE 1",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843176",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25097 Olympia Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Punta Gorda",
            "state": "FL",
            "postal_code": "339503914",
            "country_code": "US",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14095 Cortez Blvd",
            "address_purpose": "LOCATION",
            "city": "Brooksville",
            "state": "FL",
            "postal_code": "346135794",
            "country_code": "US",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "SULTAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "59759",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME135477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mind and Muscle Counseling LLC
• Mind-Full Psychiatric Wellness PLLC
• Mindmetrics
• James Tyler Minton, PT, DPT
• Steven C Mirabello, MD
• Larisa Mirzoyants
• Kendal Kristina Mitchell, LMHC
• Paul E Mitchell, M.D.
• Vimesh Kiritkumar Mithani, MD
• Maria Mitsotakis, APRN

• Dermatology Physician in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.