Organization Active NPI

Suncoast Orthopaedic Surgery & Sports Medicine, P.a.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Venice, FL
National Provider Identifier
1982638730
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
SUNCOAST ORTHOPAEDIC SURGERY & SPORTS MEDICINE, P.A.
Practice address
3030 Executive Dr
Venice, FL 34292-2613
Phone
(941) 485-1505
Fax
(941) 492-4065
NPI assigned
Jul 10, 2006
Last updated
Jul 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Dr. Joseph Noah, M.D.NPI 1295708998
Title
Owner/President
Phone
(941) 485-1505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X NU Primary

Addresses

Primary practice location

3030 Executive Dr
Venice, FL 34292-2613

Mailing address

3030 Executive Dr
Venice, FL 34292-2613
Phone (941) 485-1505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051021000760 FL Part B Supplier - Clinic/Group Practice 0648296285 Receives reassigned benefits from 18 practitioners
Practice locations: Englewood, FL; Venice, FL
O20100930078820 FL DME Supplier - Physician - Family PracticeDME Supplier - Medical Supply Company 0648296285 Practice locations: Venice, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Suncoast Orthopaedic Surgery & Spor3030 Executive Dr, Venice, FL 34292-2613(941) 485-1505 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Surgical Dressings Accepts assignmentParticipating since Jan 1, 2001

National Provider Directory

National Provider Directory

Locations

3030 Executive Dr
Venice, FL 34292
Phone (941) 485-1505

836 Sunset Lake Blvd
Ste 205
Venice, FL 34292
Phone (941) 485-1505

836 Sunset Lake Blvd
Ste 205A
Venice, FL 34292
Phone (941) 485-1505

836 Sunset Lake Blvd
Ste A205
Venice, FL 34292
Phone 9414851505113

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1982638730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 EXECUTIVE DR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342922613",
            "telephone_number": "941-485-1505",
            "fax_number": "941-492-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 EXECUTIVE DR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342922613",
            "telephone_number": "941-485-1505",
            "fax_number": "941-492-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST ORTHOPAEDIC SURGERY & SPORTS MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "NOAH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "941-485-1505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.