Individual provider Active NPI

James D Dellavecchia, PA

  • Surgical Physician Assistant
  • Sarasota, FL
National Provider Identifier
1801085956
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PAT 9104309 Issued in FL
Practice address
5741 Bee Ridge Rd
Suite 280
Sarasota, FL 34233-5064
Phone
(941) 365-0655
NPI assigned
Oct 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PAT 9104309 FL Primary

Addresses

Primary practice location

5741 Bee Ridge Rd
Suite 280
Sarasota, FL 34233-5064

Mailing address

5741 Bee Ridge Rd
Suite 280
Sarasota, FL 34233-5064

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080128000195 FL Practitioner - Physician Assistant 8628150836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6050 Cattleridge Blvd
Sarasota, FL 34232-6014
Phone (941) 365-0655

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT 9104309FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy White & Riggs Orthopedic Associates CurrentSince Sep 18, 2007 Accepting new patients
Patrice Callahan MD PA Past Accepting new patients

Locations

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

5741 Bee Ridge Rd
Ste 280
Sarasota, FL 34233
Phone (941) 365-0655

6050 Cattleridge Blvd
Ste 201
Sarasota, FL 34232
Phone (941) 365-0655

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1801085956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5741 BEE RIDGE RD",
            "address_2": "SUITE 280",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342335064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5741 BEE RIDGE RD",
            "address_2": "SUITE 280",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342335064",
            "telephone_number": "941-365-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLAVECCHIA",
        "first_name": "JAMES",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PAT 9104309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.