Active NPI
Patricia Carol Sandiford, MD
- Pediatrics Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD064688L
- Practice address
- 555 S 43Rd St
Health Center #3
Philadelphia, PA 19104-4408 - Phone
- (215) 685-7504
- Fax
- (215) 685-7551
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD064688L | PA | Primary |
Addresses
Primary practice location
555 S 43Rd St
Health Center #3
Philadelphia, PA 19104-4408
Mailing address
500 S Broad St
Suite 360
Philadelphia, PA 19146-1613
Phone (215) 685-6769
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0854786000 | Other | IBC PERSONAL CHOICE KHPE | |
| 01691666 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD064688L | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Philadelphia | Current | Accepting new patients | |
| City of Philadelphia | Current | Accepting new patients | |
| City of Philadelphia | Current | Accepting new patients | |
| City of Philadelphia | Past | Accepting new patients |
Locations
555 S 43rd St
#3
Philadelphia, PA 19104
Phone (215) 685-7504
1101 Market St
Fl 10
Philadelphia, PA 19107
4400 Haverford Ave
Philadelphia, PA 19104
Phone (215) 685-7504
500 S Broad St
Ste 360
Philadelphia, PA 19146
555 S 43rd St
Philadelphia, PA 19104
Phone (215) 685-7500
4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600
Interoperability endpoints
- patricia.sandiford@pdphahs.eclinicaldirectplus.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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1942317094
-
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1144337189
-
- Clinical Medical Laboratory
- Phila, PA
- NPI 1689688798
-
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1427165307
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424217600000",
"number": "1033210455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S BROAD ST",
"address_2": "SUITE 360",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191461613",
"telephone_number": "215-685-6769",
"fax_number": "215-685-6732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 S 43RD ST",
"address_2": "HEALTH CENTER #3",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044408",
"telephone_number": "215-685-7504",
"fax_number": "215-685-7551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDIFORD",
"first_name": "PATRICIA",
"middle_name": "CAROL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2015-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD064688L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC PERSONAL CHOICE KHPE",
"identifier": "0854786000",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01691666",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.