NPIMap

Individual provider Active NPI

Patricia A. Ceravolo, P.A.

  • Physician Assistant
  • Sarasota, FL
National Provider Identifier
1871562306
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9101506 Issued in FL
Practice address
2001 Siesta Dr
Suite 201
Sarasota, FL 34239-5200
Phone
(941) 365-5582
Fax
(941) 365-5581
NPI assigned
Mar 16, 2006
Last updated
Nov 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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 PA9101506 FL Primary

Addresses

Primary practice location

2001 Siesta Dr
Suite 201
Sarasota, FL 34239-5200

Mailing address

2001 Siesta Dr
Suite 201
Sarasota, FL 34239-5200
Phone (941) 365-5582

Other identifiers 2

IdentifierTypeStateIssuer
59-2537613OtherFLTAX ID
E6959WOtherFLMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040224000996 FL Practitioner - Physician Assistant 2860388188 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9101506FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. Physician Assistant Past Accepting new patients
Associates in Medicine & Surgery LLC PastSince Jun 28, 2021 Accepting new patients
Cary L Dunn M D P a Past Accepting new patients
Naples Center for Dermatology & Riverchase Dermatology Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: pceravolo@onspotdermatology.emadirect.md

Organizations & group practices 6

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1871562306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SIESTA DR",
            "address_2": "SUITE 201",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342395200",
            "telephone_number": "941-365-5582",
            "fax_number": "941-365-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SIESTA DR",
            "address_2": "SUITE 201",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342395200",
            "telephone_number": "941-365-5582",
            "fax_number": "941-365-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERAVOLO",
        "first_name": "PATRICIA",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "59-2537613",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "E6959W",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.