Individual provider Active NPI

Sandi Pino, MSN, CRNP, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Plymouth Meeting, PA
National Provider Identifier
1043877897
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP020359 Issued in PA
Practice address
2250 Hickory Rd Ste 140
Plymouth Meeting, PA 19462-1047
Phone
(610) 379-2904
Fax
(610) 840-0528
NPI assigned
May 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP020359 PA
Primary Care Nurse Practitioner 363LP2300X SP020359 PA
Gerontology Nurse Practitioner 363LG0600X SP020359 PA Primary

Addresses

Primary practice location

2250 Hickory Rd Ste 140
Plymouth Meeting, PA 19462-1047

Mailing address

PO Box 37492
Belfast, ME 04915-1216
Phone (610) 379-2904

Other practice location 1

20320 Northwest Fwy Ste 400A
Jersey Village, TX 77065-5620
Phone (346) 345-2092

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918004474 PA Practitioner - Nurse Practitioner 4284042516 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restore First Health PennGroup PAC ID 8820435316, 8 clinicians
Kane Wound Care LLCGroup PAC ID 2567591274, 53 clinicians

Practice addresses (Care Compare)

2250 Hickory Rd
Suite 140
Plymouth Meeting, PA 19462-1047
Phone (610) 379-2904

9501 State Rd
Philadelphia, PA 19114-3053
Phone (215) 632-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP020359PAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Medical Services LLC CurrentSince Aug 15, 2024 Accepting new patients
Restore First Health Penn CurrentSince Jun 30, 2025 Accepting new patients
Kane Wound Care LLC CurrentSince Jan 15, 2026 Accepting new patients
Medical Director Services PC CurrentSince Jan 12, 2025 Accepting new patients
Tandigm Care Solutions, LLC PastSince Aug 1, 2017 Accepting new patients

Locations

3626 US Highway 1
Princeton, NJ 08540
Phone (609) 243-0445

743 Mahoning St
Milton, PA 17847
Phone (570) 742-2681

1427 Horsham Rd
North Wales, PA 19454
Phone (215) 277-7132

1425 Horsham Rd
North Wales, PA 19454
Phone (215) 284-5398

9501 State Rd
Philadelphia, PA 19114
Phone (215) 632-5700

2250 Hickory Rd
Ste 140
Plymouth Mtng, PA 19462
Phone (610) 379-2904

8601 Stenton Ave
Wyndmoor, PA 19038
Phone (215) 233-6200

20320 Northwest Fwy
Ste 400A
Jersey Village, TX 77065
Phone (281) 397-0777

Interoperability endpoints

  • Direct secure messaging: sandi.pino.1@28696.direct.athenahealth.com
  • Direct secure messaging: sandiann.pino.p1@direct.tandigmhealth.nextgenshare.com

Organizations & group practices 5

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1043877897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37492",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049151216",
            "telephone_number": "610-379-2904",
            "fax_number": "610-840-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 HICKORY RD STE 140",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621047",
            "telephone_number": "610-379-2904",
            "fax_number": "610-840-0528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20320 Northwest Fwy Ste 400A",
            "address_purpose": "LOCATION",
            "city": "Jersey Village",
            "state": "TX",
            "postal_code": "770655620",
            "country_code": "US",
            "telephone_number": "346-345-2092",
            "fax_number": "281-883-4395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINO",
        "first_name": "SANDI",
        "credential": "MSN, CRNP, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP020359",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP020359",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP020359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

Verify at the official NPI Registry.