Individual provider Active NPI

Sandra Dormeus

  • Family Nurse Practitioner
  • Springfield, PA
National Provider Identifier
1104230267
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP013657 Issued in PA
Practice address
795 Baltimore Pike
Springfield, PA 19064-3967
Phone
(866) 389-2727
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP013657 PA Primary

Addresses

Primary practice location

795 Baltimore Pike
Springfield, PA 19064-3967

Mailing address

795 Baltimore Pike
Springfield, PA 19064-3967
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140908000607 PA Practitioner - Nurse Practitioner 7719105691 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Pennsylvania LLCGroup PAC ID 5395827307, 84 clinicians

Practice addresses (Care Compare)

1218 E Lancaster Ave
Bryn Mawr, PA 19010-2616
Phone (866) 398-2727

1500 Spruce St
Philadelphia, PA 19102-4502
Phone (866) 389-2727

312 S Henderson Rd
King of Prussia, PA 19406-2408
Phone (866) 389-2727

5001 Township Line Rd
Drexel Hill, PA 19026-4821
Phone (866) 389-2727

795 Baltimore Pike
Springfield, PA 19064-3967
Phone (866) 389-2727

840 S Valley Forge Rd
Lansdale, PA 19446-4242
Phone (866) 398-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Pennsylvania LLC Family CurrentSince Jul 7, 2014 Accepting new patients
Minuteclinic Video Virtual Care, PLLC Family CurrentSince Dec 20, 2022 Accepting new patients

Locations

1218 E Lancaster Ave
Bryn Mawr, PA 19010
Phone (610) 519-1920

840 S Valley Forge Rd
Lansdale, PA 19446
Phone (215) 362-6303

1500 Spruce St
Philadelphia, PA 19102
Phone (215) 790-3290

795 Baltimore Pike
Springfield, PA 19064
Phone (610) 690-5100

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1104230267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 BALTIMORE PIKE",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643967",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 BALTIMORE PIKE",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643967",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMEUS",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP013657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

Verify at the official NPI Registry.