Individual provider Active NPI

Sandra Hegarty, M.D

  • Pediatrics Physician
  • Port Charlotte, FL
National Provider Identifier
1083859326
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME83768 Issued in FL
Practice address
4300 Kings Hwy
#500
Port Charlotte, FL 33980-2917
Phone
(239) 344-2325
Fax
(941) 764-6176
NPI assigned
Dec 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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 ME83768 FL Primary

Addresses

Primary practice location

4300 Kings Hwy
#500
Port Charlotte, FL 33980-2917

Mailing address

PO Box 919771
Orlando, FL 32891-9771
Phone (239) 278-3600

Other identifiers 1

IdentifierTypeStateIssuer
000805000MedicaidFL

Other names 1

  • Sandra Morris Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20111222000465 FL Practitioner - Pediatric Medicine 0840273660

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children's Physician Group Pediatrics Past Accepting new patients
Family Health Centers of Southwest Florida Inc Past Accepting new patients

Organizations & group practices 2

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": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1083859326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919771",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328919771",
            "telephone_number": "239-278-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 KINGS HWY",
            "address_2": "#500",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339802917",
            "telephone_number": "239-344-2325",
            "fax_number": "941-764-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEGARTY",
        "first_name": "SANDRA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME83768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000805000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "MORRIS",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.