MEDICARE: DR. BRETT MATTHEW SASSEEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	ME82025	FL
2	207RI0011X	Interventional Cardiology Physician	ME82025	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5606582	OTHER	FL	AETNA
2	58520	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194728360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRETT MATTHEW SASSEEN MD

Provider Business Mailing Address
First Line	:	770 W GRANADA BLVD STE 101
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-5179
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	61 MEMORIAL MEDICAL PKWY STE 2811
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-5999
Country	:	US
Telephone Number	:	386-586-1955
Fax Number	:	386-586-1959

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/23/2026

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