Individual provider Active NPI

Marie V Sanford, MD

  • Pediatric Adolescent Medicine Physician
  • New York, NY
National Provider Identifier
1043357585
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
190779 Issued in NY
Practice address
2315 Broadway
New York, NY 10024
Phone
(646) 962-2110
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 64457 CT
Pediatric Adolescent Medicine Physician 2080A0000X 190779 NY Primary

Addresses

Primary practice location

2315 Broadway
New York, NY 10024

Mailing address

67 Morton St Apt 2B
New York, NY 10014-6743

Other practice location 1

12 W 72nd St
New York, NY 10023-4163
Phone (646) 962-7800

Other practice location 2

2315 Broadway
New York, NY 10024
Phone (646) 962-2110

Other practice location 3

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msanford51064@connecticutchildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100203000649 NY Practitioner - Pediatric Medicine 7618010331 Reassigns benefits to 1 organization
I20191125001996 CT Practitioner - Pediatric Medicine 7618010331 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64457CTMDPediatrics Physician
190779NYMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Jul 1, 2013 Accepting new patients
Weill Medical College of Cornell Pediatrics Current Accepting new patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Nov 1, 2019 Accepting new patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Nov 1, 2019 Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 1, 2013 Accepting new patients
Westside Pediatrics PC Past Accepting new patients

Locations

10 Columbus Blvd
Ste 403
Hartford, CT 06106
Phone (860) 837-7250

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

2315 Broadway
New York, NY 10024
Phone (212) 746-3278

12 W 72nd St
New York, NY 10023
Phone (212) 746-7800

Organizations & group practices 6

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1043357585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MORTON ST APT 2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100146743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10024",
            "telephone_number": "646-962-2110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 W 72nd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100234163",
            "country_code": "US",
            "telephone_number": "646-962-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2315 Broadway",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10024",
            "country_code": "US",
            "telephone_number": "646-962-2110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-545-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "MARIE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "64457",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "190779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msanford51064@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.