Individual provider Active NPI

Anette Marie Sandoval, ARNP, CNM

  • Advanced Practice Midwife
  • Melbourne, FL
National Provider Identifier
1023274438
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
ARNP3257842 Issued in FL
Practice address
330 E Hibiscus Blvd
Melbourne, FL 32901-3155
Phone
(321) 724-2229
Fax
(321) 728-6668
NPI assigned
Aug 5, 2008
Last updated
Aug 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X ARNP3257842 FL Primary

Addresses

Primary practice location

330 E Hibiscus Blvd
Melbourne, FL 32901-3155

Mailing address

330 E Hibiscus Blvd
Melbourne, FL 32901-3155
Phone (321) 724-2229

Other practice location 1

1765 Berglund Ln
Viera, FL 32940-6230
Phone (321) 724-2229

Other identifiers 1

IdentifierTypeStateIssuer
001114800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160202001418 FL Practitioner - Certified Nurse Midwife (CNM) 5597814475 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Woman Care LLCGroup PAC ID 5395807218, 607 clinicians

Practice addresses (Care Compare)

330 E Hibiscus Blvd
Melbourne, FL 32901-3155
Phone (321) 724-2229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
ARNP3257842FLMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Health Alliance Inc CurrentSince Nov 12, 2018 Accepting new patients
Brevard Health Alliance, Inc. CurrentSince Nov 12, 2018 Accepting new patients
Womencare PA Past Accepting new patients

Locations

2120 Sarno Rd
Melbourne, FL 32935
Phone (321) 952-9696

Interoperability endpoints

  • Direct secure messaging: anette.ferrell.2@2183.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1023274438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E HIBISCUS BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013155",
            "telephone_number": "321-724-2229",
            "fax_number": "321-728-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E HIBISCUS BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013155",
            "telephone_number": "321-724-2229",
            "fax_number": "321-728-6668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1765 Berglund Ln",
            "address_purpose": "LOCATION",
            "city": "Viera",
            "state": "FL",
            "postal_code": "329406230",
            "country_code": "US",
            "telephone_number": "321-724-2229",
            "fax_number": "321-728-6681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "ANETTE",
        "middle_name": "MARIE",
        "credential": "ARNP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "ARNP3257842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001114800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.