SANDRA D FANTAUZZI (PAC) – Physician Assistant, NPI 1982684205
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SANDRA D FANTAUZZI (PAC)
2285, Corporate Circle, Green Valley Ranch, Henderson, Clark County, Nevada, 89074, United States
STE 200
HENDERSON, NV 890747759
Phone: (702) 360-2763
Fax: (949) 783-2880
Type: Mailing
Ponce de Leon Boulevard, Sun 'n Lake of Sebring, Sebring, Highlands County, Florida, 33872, United States
SEBRING, FL 338722164
Phone: (863) 385-1244
Fax: (863) 385-6086
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 67 Open Payments records for all available years, with a total value of $3,783.
Total Amount is formed as General ($3,783) + Research ($0) + Ownership ($0) = $3,783.
Last reported payment date: 2024-12-24 • Largest payer in this snapshot: Almirall LLC ($600).
Total Amount
$3,783
General + Research + Ownership
Payments
67
Total payment records
General Amount
$3,783
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Almirall LLC | $600 |
| PFIZER INC. | $480 |
| Journey Medical Corporation | $345 |
| GENZYME CORPORATION | $337 |
| Arcutis Biotherapeutics, Inc. | $293 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-12-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20161203000269 | I | Physician Assistant | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 262 | 31 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 132 | 62 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 66 | 38 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 50 | 33 | $0 |
| 17004 | Destruction of precancer skin growth, 15 or more growths | 43 | 26 | $0 |
Insurance plans in this area (ZIP 89074)
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