Alexander Penn

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9115886 Issued in FL

Practice address

5731 Bee Ridge Rd
Sarasota, FL 34233-5056

Phone

(904) 517-9317

NPI assigned

Jun 30, 2022

Last updated

Jun 30, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: alexander.penn.1@25843.direct.athenahealth.com

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.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1962134577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GREENHAVEN CIR",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346774805",
            "telephone_number": "904-517-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5731 BEE RIDGE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342335056",
            "telephone_number": "904-517-9317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "ALEXANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9115886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Peltz
• Pelvic Pain Diagnostic and Treatment Center
• Claudia Penarenas, BSW, BA
• Penge Chiropractic Health Center PA
• Joseph J Penge, DC
• Christopher Robert Penn, RMHCI
• David H Penoyer Jr., CRNA
• Viroje Pensirikul, MD
• Angela M Penzo, PT
• Cheryl Peppers, LCSW

• Medical Physician Assistant in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.