NPIMap

Individual provider Active NPI

Agustin C Sanz, MD

  • Internal Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1902841661
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME63215 Issued in FL
Practice address
293 NW Peacock Blvd Ste 101-104
Port Saint Lucie, FL 34986-2222
Phone
(772) 335-9600
Fax
(772) 879-4478
NPI assigned
Jun 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME63215 FL Primary

Addresses

Primary practice location

293 NW Peacock Blvd Ste 101-104
Port Saint Lucie, FL 34986-2222

Mailing address

293 NW Peacock Blvd Ste 101-104
Port Saint Lucie, FL 34986-2222
Phone (772) 335-9600

Other identifiers 1

IdentifierTypeStateIssuer
18918MedicaidFL

Other names 1

  • Agustin C. Sanz Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address AGUSTIN.SANZ@hca4.eclinicaldirectplus.com

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
I20101227000154 FL Practitioner - Internal Medicine 6709074396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lucie Medical Specialists LLCGroup PAC ID 1456430487, 39 clinicians

Practice addresses (Care Compare)

1881 SE Tiffany Ave
Port Saint Lucie, FL 34952-7567

2505 SW Martin Hwy
Palm City, FL 34990-3149
Phone (772) 288-1015

293 NW Peacock Blvd
Port Saint Lucie, FL 34986-2222

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Lucie Medical Specialists LLC Internal Medicine CurrentSince Apr 1, 2011 Accepting new patients
Lawnwood Cardiovascular Surgery LLC Past Accepting new patients

Locations

2505 SW Martin Hwy
Palm City, FL 34990
Phone (772) 288-0060

1881 SE Tiffany Ave
Ste 306
Port Saint Lucie, FL 34952
Phone (772) 398-7822

1881 SE Tiffany Ave
Ste 308
Port Saint Lucie, FL 34952
Phone (772) 398-7822

293 NW Peacock Blvd
Ste 101104
Port St Lucie, FL 34986
Phone (772) 336-6601

140 SW Chamber Ct
Ste 100
Port St Lucie, FL 34986
Phone (772) 873-0303

1420 SW Saint Lucie West Blvd
Ste 103
Port St Lucie, FL 34986
Phone (561) 296-1188

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: agustin.sanz.1@17433.direct.athenahealth.com
  • Direct secure messaging: agustin.sanz@hca4.eclinicaldirectplus.com

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 12

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1902841661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 NW PEACOCK BLVD STE 101-104",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862222",
            "telephone_number": "772-335-9600",
            "fax_number": "772-879-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 NW PEACOCK BLVD STE 101-104",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862222",
            "telephone_number": "772-335-9600",
            "fax_number": "772-879-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANZ",
        "first_name": "AGUSTIN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME63215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18918",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AGUSTIN.SANZ@hca4.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "293 NW Peacock Blvd Ste 101-104",
            "city": "Port Saint Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349862222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AGUSTIN",
            "last_name": "SANZ",
            "middle_name": "C.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.