Individual provider Active NPI

Sophia Gevoy

  • Dermatology Physician
  • New Port Richey, FL
National Provider Identifier
1952909467
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
PA9113698 Issued in FL
Practice address
8209 State Road 54
New Port Richey, FL 34655-3016
Phone
(727) 569-1055
NPI assigned
Oct 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X PA9113698 FL Primary

Addresses

Primary practice location

8209 State Road 54
New Port Richey, FL 34655-3016

Mailing address

2202 N Lois Ave Apt 1121
Tampa, FL 33607-2537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210218000449 FL Practitioner - Physician Assistant 2466867700 Reassigns benefits to 2 organizations
I20231208003349 MI Practitioner - Physician Assistant 2466867700 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc Dermatology CurrentSince Apr 1, 2021 Accepting new patients
Leavitt Medical Associates of Florida Inc Dermatology CurrentSince Apr 1, 2021 Accepting new patients
Forest Drive Physicians Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Alan Bolton, MD, PC PastSince Mar 1, 1999 Accepting new patients

Locations

1905 Clint Moore Rd
Ste 103
Boca Raton, FL 33496
Phone (561) 241-4474

82245 Overseas Hwy
Islamorada, FL 33036
Phone (305) 664-0700

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

8209 State Road 54
New Prt Rchy, FL 34655
Phone (727) 569-1055

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

Organizations & group practices 7

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": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1952909467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 N LOIS AVE APT 1121",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336072537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8209 STATE ROAD 54",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346553016",
            "telephone_number": "727-569-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEVOY",
        "first_name": "SOPHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "PA9113698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.