Individual provider Active NPI

Stephen Jeffrey Sanders, AU.D.

  • Audiologist
  • Mission Viejo, CA
National Provider Identifier
1093716847
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU1156 Issued in CA
Practice address
26726 Crown Valley Pkwy
Suite 210
Mission Viejo, CA 92691-6364
Phone
(949) 364-4361
Fax
(949) 364-7124
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU1156 CA Primary
Hearing Instrument Specialist 237700000X HA2517 CA

Addresses

Primary practice location

26726 Crown Valley Pkwy
Suite 210
Mission Viejo, CA 92691-6364

Mailing address

26726 Crown Valley Pkwy
Suite 210
Mission Viejo, CA 92691-6364
Phone (949) 364-4361

Other identifiers 5

IdentifierTypeStateIssuer
W15940OtherCAGROUP PTAN
AS004ZOtherCAINDIVIDUAL PTAN
AS362ZOtherCAINDIVIDUAL PTAN
AU0011560OtherCAMEDI-CAL ID #
W8109OtherCAGROUP PTAN

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
AU1156CAMDAudiologist
HA2517CAMDHearing Instrument Specialist

Interoperability endpoints

  • Direct secure messaging: stephen.sanders.p19@direct.monarchhealthcare.nextgenshare.com
  • Direct secure messaging: stephen.sanders.p21@direct.monarchhealthcare.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1093716847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26726 CROWN VALLEY PKWY",
            "address_2": "SUITE 210",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916364",
            "telephone_number": "949-364-4361",
            "fax_number": "949-364-7124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26726 CROWN VALLEY PKWY",
            "address_2": "SUITE 210",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916364",
            "telephone_number": "949-364-4361",
            "fax_number": "949-364-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "STEPHEN",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU1156",
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA2517",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "W15940",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "AS004Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "AS362Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL ID #",
            "identifier": "AU0011560",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "W8109",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.