Individual provider Active NPI

Patricia Carol Sandiford, MD

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1033210455
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD064688L Issued in PA
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

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0854786000OtherIBC PERSONAL CHOICE KHPE
01691666MedicaidPA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110524000690 PA Practitioner - Pediatric Medicine 1456537646 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD064688LPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Jul 21, 2014 Accepting new patients
City of Philadelphia CurrentSince Jul 21, 2014 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.