Individual provider Active NPI

Sarah Randrup Proffit, NP-C

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1104459270
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R181863 Issued in MD
Practice address
228 Park Ave S Ste 16389
New York, NY 10003-0103
Phone
(646) 876-8455
NPI assigned
Feb 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1227411 TX
Family Nurse Practitioner 363LF0000X TPAN4279 FL
Family Nurse Practitioner 363LF0000X 209.034748 IL
Family Nurse Practitioner 363LF0000X 116686-23 NH
Family Nurse Practitioner 363LF0000X 14272676-4405 UT
Family Nurse Practitioner 363LF0000X R181863 MD Primary
Registered Nurse 163W00000X R191963 MD
Family Nurse Practitioner 363LF0000X SP035021 PA
Family Nurse Practitioner 363LF0000X 26NJ15493100 NJ

Addresses

Primary practice location

228 Park Ave S Ste 16389
New York, NY 10003-0103

Mailing address

169 Madison Ave Ste 38114
New York, NY 10016-5101
Phone (646) 876-8455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20200504000041 MD Practitioner - Nurse Practitioner 3173954393 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

1640 Woodbrooke Dr
Salisbury, MD 21804-8501
Phone (410) 912-5640

Hospital & facility affiliations

  • Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019

Merit-based Incentive Payment System (MIPS)

Final score
82.92 of 100Reported as group
Quality
74.47
Promoting interoperability
92
Improvement activities
40
Cost
75.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R191963MDMDRegistered Nurse
TPAN4279FLMDFamily Nurse Practitioner
209.034748ILMDFamily Nurse Practitioner
R181863MDMDFamily Nurse Practitioner
116686-23NHMDFamily Nurse Practitioner
26NJ15493100NJMDFamily Nurse Practitioner
SP035021PAMDFamily Nurse Practitioner
1227411TXMDFamily Nurse Practitioner
14272676-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Digestive Care LLC CurrentSince Sep 1, 2020 Accepting new patients
Capital Digestive Care, LLC CurrentSince Sep 1, 2020 Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Aug 1, 2022 Accepting new patients
Tidalhealth Specialty Care, LLC Past Accepting new patients
J O Meadows MD PA PastSince Mar 29, 2020 Accepting new patients

Locations

9315 Ocean Hwy
Ste B
Delmar, MD 21875
Phone (410) 707-3979

4801 Dorsey Hall Dr
Ste 120
Ellicott City, MD 21042
Phone (410) 730-9363

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

1640 Woodbrooke Dr
Salisbury, MD 21804
Phone (410) 912-5640

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1104459270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 MADISON AVE STE 38114",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165101",
            "telephone_number": "646-876-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 PARK AVE S STE 16389",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100030103",
            "telephone_number": "646-876-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFFIT",
        "first_name": "SARAH",
        "middle_name": "RANDRUP",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1227411",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "TPAN4279",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.034748",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "116686-23",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "14272676-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R181863",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R191963",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP035021",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ15493100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.