Individual provider Active NPI

Bryan Sadsarin

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1841912300
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
14810 Old Saint Augustine Rd Ste 207
Jacksonville, FL 32258-2558
Phone
(904) 217-7450
NPI assigned
Sep 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

14810 Old Saint Augustine Rd Ste 207
Jacksonville, FL 32258-2558

Mailing address

1436 Guardian Dr
Jacksonville, FL 32221-8027

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
I20221205001715 FL Practitioner - Physician Assistant 7416326996 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Nov 27, 2023 Accepting new patients

Locations

2 Shircliff Way
Ste 200
Jacksonville, FL 32204
Phone (904) 308-2006

Interoperability endpoints

  • Direct secure messaging: bryan.sadsarin.1@8967.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1841912300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 GUARDIAN DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322218027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14810 OLD SAINT AUGUSTINE RD STE 207",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582558",
            "telephone_number": "904-217-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADSARIN",
        "first_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.