Individual provider Active NPI

Michael Andrew Sonnenberg, MD

  • Diagnostic Radiology Physician
  • Pensacola, FL
National Provider Identifier
1801002324
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME122246 Issued in FL
Practice address
5151 N 9TH Ave
Pensacola, FL 32504-8721
Phone
(850) 416-6020
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301086534 MI
Diagnostic Radiology Physician 2085R0202X ME122246 FL Primary

Addresses

Primary practice location

5151 N 9TH Ave
Pensacola, FL 32504-8721

Mailing address

PO Box 9210
Pensacola, FL 32513-9210
Phone (850) 476-8602

Other identifiers 1

IdentifierTypeStateIssuer
014670700MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150602002945 FL Practitioner - Diagnostic Radiology 9537347703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Destin Regional Imaging Center LLCGroup PAC ID 8921050782, 3 clinicians

Practice addresses (Care Compare)

7800 US Hwy 98 W
Miramar Beach, FL 32550-7228
Phone (850) 278-3556

Hospital & facility affiliations

  • Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292
  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • Ascension Sacred Heart Gulf Hospital, Port Saint Joe, FL, CCN 100313
  • Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026
  • North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301086534MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Destin Regional Imaging Center LLC Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Destin Regional Imaging Center LLC Diagnostic Radiology PastSince May 29, 2022 Accepting new patients

Locations

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

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 and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1801002324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9210",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325139210",
            "telephone_number": "850-476-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048721",
            "telephone_number": "850-416-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONNENBERG",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301086534",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME122246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014670700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.