Individual provider Active NPI

Sandra Onyeagoro, M.D.

  • Psychiatry Physician
  • Ellicott City, MD
National Provider Identifier
1104053362
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0082306 Issued in MD
Practice address
4100 College Ave
Ellicott City, MD 21043-5506
Phone
(443) 364-5500
NPI assigned
Jun 16, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Psychiatry Physician 2084P0800X 2013-00120 NC
Psychiatry Physician 2084P0800X D0082306 MD Primary

Addresses

Primary practice location

4100 College Ave
Ellicott City, MD 21043-5506

Mailing address

7628 Elmcrest Rd
Hanover, MD 21076-1873
Phone (301) 326-7818

Other practice location 1

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 277-1800

Other identifiers 1

IdentifierTypeStateIssuer
1104053362MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, DC, VA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20140210000229 NC Practitioner - Psychiatry 8921237256 Reassigns benefits to 2 organizations
I20230126003258 DC Practitioner - Psychiatry 8921237256 Reassigns benefits to 1 organization
I20230914001605 VA Practitioner - Psychiatry 8921237256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Shore Community MH Mr Sas Services BoardGroup PAC ID 8729185095, 17 clinicians

Practice addresses (Care Compare)

19056 Greenbush Rd
Parksley, VA 23421-2510
Phone (757) 665-1260

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0082306MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H. Cone Memorial Hospital Operating Corporation Current Accepting new patients
Virginia Hospital Center Physician Group, LLC Current Accepting new patients
Virginia Hospital Center Physician Group LLC CurrentSince Jan 13, 2023 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Aug 1, 2023 Accepting new patients
Alamance Regional Medical Center, Inc. CurrentSince Aug 2, 2024 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Aug 1, 2023 Accepting new patients
Alamance Regional Medical Center, Inc CurrentSince Aug 2, 2024 Accepting new patients
Virginia Hospital Center Physician Group, LLC Psychiatry CurrentSince Jan 13, 2023 Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

700 Walter Reed Dr
Greensboro, NC 27403
Phone (336) 832-9600

1625 N George Mason Dr
Ste 345
Arlington, VA 22205
Phone (703) 717-4400

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

1200 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 372-3900

621 Emancipation Hwy
Ste 201
Fredericksburg, VA 22401
Phone (540) 372-2028

Organizations & group practices 9

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": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104053362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7628 ELMCREST RD",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761873",
            "telephone_number": "301-326-7818",
            "fax_number": "410-799-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 COLLEGE AVE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210435506",
            "telephone_number": "443-364-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Silas Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033013",
            "country_code": "US",
            "telephone_number": "336-277-1800",
            "fax_number": "336-277-6981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONYEAGORO",
        "first_name": "SANDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2013-00120",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0082306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104053362",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.