Sandra Jean Hughes, M.D.
Individual provider Active NPI Pediatrics Physician · Tuckahoe, NY
NPI 1124295159 · NPPES record last updated Apr 28, 2021
Key facts
- NPI
- 1124295159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 249465 (NY)
- Practice address
- 115 Main St Ste 301
Tuckahoe, NY 10707-2949 - Phone
- (914) 771-7070
- Fax
- (914) 771-7073
- NPI assigned
- May 8, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180329000953 | NY | Practitioner - Pediatric Medicine | 3375805419 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 249465 | NY | MD | Pediatrics Physician |
Practice roles (6 of 10)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Avenue Pediatrics, P.C. | Pediatrics | Current |
Accepting new patients |
| Refuah Health Center, Inc. | Current |
Accepting new patients | |
| Refuah Health Center Inc | Current |
Accepting new patients | |
| Maimonides Medical Center | Current | Accepting new patients | |
| Village Pediatric Group PLLC | Pediatrics | Past |
Accepting new patients |
| Boston Children'S Health Physicians, LLP | Pediatrics | Past |
Accepting new patients |
Locations
3400 Cannon Pl
Bronx, NY 10463
Phone (718) 694-9000
728 N Main St
New Square, NY 10977
Phone (845) 354-9301
5 Twin Ave
Spring Valley, NY 10977
Phone 84535493001249
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- sandra.petty.p1@direct.ezramedical.nextgenshare.com
- sandrapetty@mai.allscriptsdirect.net
- sandra.hughes.1@32321.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 249465 | NY | Yes |
Addresses
Primary practice location
115 Main St Ste 301
Tuckahoe, NY 10707-2949
Mailing address
90 N Grant Ave
Congers, NY 10920-1935
Phone (910) 393-9190
Other names
- Dr. Sandra Jean Petty
Other providers in Tuckahoe, NY
- Frank Graziano
- Jeanette N Green
- Alan Jay Guber
- Mariana Gutierrez
- Hudson Psychology Associates, LLP
- Cindy S. Hyatt
- Ardith Inlaw
- Nicholas Vincent Isabella III
- Monique Johnson
- Jonathan David, MD, PC
All providers in Tuckahoe, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.