Sandra D Fantauzzi, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9102455 Issued in FL

Practice address

4420 Sun N Lake Blvd
Sebring, FL 33872-2164

Phone

(863) 385-1244

Fax

(863) 385-6086

NPI assigned

Jan 20, 2006

Last updated

May 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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 CA

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

Merit-based Incentive Payment System (MIPS)

Final score

85.17 of 100Reported as group

Quality

74.51

Promoting interoperability

92

Improvement activities

40

Cost

82.72

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sandra.fantauzzi.p1@direct.lakeside.nextgenshare.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.

• J Robert West, M.D., Inc

  dba Southern California Dermatology

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1932154788
  Medicare reassignment NPD
• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642
  Medicare reassignment
• Pure Dermatology

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1912246570
  Medicare reassignment
• UC Regents

  dba UCI Department of Medicine

  • Infectious Disease Physician
  • Orange, CA
  • NPI 1760430847
  Medicare reassignment
• UC Regents

  dba UCI Department of Medicine

  • Hematology & Oncology Physician
  • Orange, CA
  • NPI 1356399380
  NPD
• UC Regents

  dba UCI Department of Medicine

  • Pulmonary Disease Physician
  • Orange, CA
  • NPI 1629026729
  NPD
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD (past)
• Robert a. Norman, D.O., P.a.

  dba Dr. Robert A. Norman Dermatology

  • Dermatology Physician
  • Riverview, FL
  • NPI 1952440711
  NPD (past)
• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390
  NPD (past)
• J. Robert West, M.D., Inc

  dba West Dermatology

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1114567997
  NPD (past)
• Lorrie J Klein MD Apc

  • Dermatology Physician
  • Laguna Niguel, CA
  • NPI 1083631808
  NPD (past)
• Surgery Center of Pure

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1285247569
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1982684205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 CORPORATE CIR",
            "address_2": "STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747759",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722164",
            "telephone_number": "863-385-1244",
            "fax_number": "863-385-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTAUZZI",
        "first_name": "SANDRA",
        "middle_name": "D",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Famillion
• Family Extended Care of Sebring, Inc.
• Family Home Health Services LLC (VitalCaring Group)
• Family Solutions of Central LLC
• Kimberly Kae Fane, PTA
• Syed Khooshal Fareeduddin, MD
• Rebecca M Farias, LPN
• Stephanie Diane Farrer, L.M.T.
• Elena F Febre, MD
• Robert E. Fell, PA-C

• Physician Assistant in Sebring, FL
• Providers in Sebring, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.
• 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.