Individual provider Active NPI

Sanford Mason, DPM

  • Podiatrist
  • Northbrook, IL
National Provider Identifier
1053328328
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016002656 Issued in IL
Practice address
425 Huehl Rd
#13
Northbrook, IL 60062-2319
Phone
(847) 504-5000
Fax
(847) 504-5015
NPI assigned
Aug 1, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016002656 IL Primary

Addresses

Primary practice location

425 Huehl Rd
#13
Northbrook, IL 60062-2319

Mailing address

425 Huehl Rd
#13
Northbrook, IL 60062-2319
Phone (847) 504-5000

Other identifiers 1

IdentifierTypeStateIssuer
016002656MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
016002656ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Podiatry Group PC Podiatrist Past Accepting new patients

Organizations & group practices 1

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1053328328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 HUEHL RD",
            "address_2": "#13",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622319",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 HUEHL RD",
            "address_2": "#13",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622319",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "SANFORD",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016002656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016002656",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.