Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1760331524 Individual Practitioner Male Practitioner

Shane William Roback , PA-C

Physician Assistant • Sarasota, FL

Professional Overview & Biography Verified Profile Summary

Shane Roback, PA-C is a registered healthcare professional specializing in Physician Assistant in Sarasota, FL. Practice services are available at 1540 S TAMIAMI TRL STE 401 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1540 S Tamiami Trl Ste 401

Sarasota, FL 342392921

Telephone 9419170060
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Sarasota, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.1 Yrs
State Avg: 11.1 Yrs
Regional Practice Density
178 Specialists

Practicing in Sarasota, FL (10376 Statewide)

Telehealth Adoption Rate
3.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-04-20
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License FL PA9121269

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

26 Associated Practitioners
Alyssa Rowe , MSN, ARNP, NP-C

Nurse Practitioner - Family

NPI 1033454400

Master of Science in Nursing, Advanced Registered Nurse Practitioner, Nurse Practitioner (Certified)

NPI 1073302014

Advanced Practice Registered Nurse, Family Nurse Practitioner

Sonya Ivanova , PA-C

Physician Assistant

NPI 1083477822

Physician Assistant (Certified)

Nancy Von Waldner , PA-C

Physician Assistant

NPI 1124501044

Physician Assistant (Certified)

NPI 1124516810

ARNPBC

Jason Gursky , APRN

Nurse Practitioner - Adult Health

NPI 1184175499

Advanced Practice Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location April 20, 2026

Registered at 1540 S TAMIAMI TRL STE 401, SARASOTA, FL 342392921 (Tel: 9419170060)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 20, 2026

Physician Assistant (License #PA9121269 in FL)

NPI Profile Active January 26, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location January 26, 2026

Registered at 19920 BRIDGETOWN LOOP, VENICE, FL 342932281 (Tel: 3157930816)

📍
Updated Business Mailing Address January 26, 2026

Registered at 19920 BRIDGETOWN LOOP, VENICE, FL 342932281

👤
Provider Name / Credentials Updated January 26, 2026

Recorded as SHANE ROBACK, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 26, 2026

Physician Assistant

🟢
Initial NPI Registration & Enumeration January 26, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1760331524
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 26, 2026
Last Update: April 20, 2026
Sole Proprietor: No

Mailing Address

19920 Bridgetown Loop

Venice, FL 342932281

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.