Individual provider Active NPI

Jessica Sander

  • Social Worker
  • Massapequa, NY
National Provider Identifier
1063324556
Registry record updated Sep 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2724697 Issued in NY
Practice address
11 Dogwood PL
Massapequa, NY 11758-2726
Phone
(347) 330-8911
NPI assigned
Sep 19, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2724697 NY Primary

Addresses

Primary practice location

11 Dogwood PL
Massapequa, NY 11758-2726

Mailing address

11 Dogwood PL
Massapequa, NY 11758-2726
Phone (347) 330-8911

Medicare participation

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1789776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789776000000",
    "number": "1063324556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 DOGWOOD PL",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582726",
            "telephone_number": "347-330-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 DOGWOOD PL",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582726",
            "telephone_number": "347-330-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDER",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-19",
        "last_updated": "2026-09-19",
        "certification_date": "2026-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "2724697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.