Individual provider Active NPI

Sandhya Susan Philip, RN, APN

  • Adult Health Nurse Practitioner
  • Mesquite, TX
National Provider Identifier
1124384078
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP125609 Issued in TX
Practice address
3865 Childress Ave
Suita a
Mesquite, TX 75150-2802
Phone
(972) 681-7246
Fax
(972) 681-1079
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP125609 TX Primary

Addresses

Primary practice location

3865 Childress Ave
Suita a
Mesquite, TX 75150-2802

Mailing address

807 Ashley PL
Mesquite, TX 75181-4205
Phone (201) 356-7986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150320000465 TX Practitioner - Nurse Practitioner 2961725643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kikkeri International PAGroup PAC ID 1254359938, 5 clinicians

Practice addresses (Care Compare)

3865 Childress Ave
Suite a
Mesquite, TX 75150-2802

3865 Childress Ave
Suite a
Mesquite, TX 75150-2808
Phone (972) 681-7246

3865 Childress Ave a
Mesquite, TX 75150-2802

3931 Joe Ramsey Blvd E
Suite D
Greenville, TX 75401-7777
Phone (972) 681-7246

Hospital & facility affiliations

  • Hunt Regional Medical Center Hospital, Greenville, TX, CCN 450352
  • Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742

Merit-based Incentive Payment System (MIPS)

Final score
93.6 of 100Reported as group
Quality
89.59
Promoting interoperability
99
Improvement activities
40
Cost
73.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP125609TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kikkeri International, PA CurrentSince Feb 20, 2015 Accepting new patients

Locations

3931 Joe Ramsey Blvd E
Ste D
Greenville, TX 75401
Phone (469) 320-1237

3865 Childress Ave
Ste B
Mesquite, TX 75150
Phone (318) 469-4470

3865 Childress Ave
Ste A
Mesquite, TX 75150
Phone (469) 554-0213

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDGDAA

Organizations & group practices 1

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 2

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1124384078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 ASHLEY PL",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751814205",
            "telephone_number": "201-356-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3865 CHILDRESS AVE",
            "address_2": "SUITA A",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502802",
            "telephone_number": "972-681-7246",
            "fax_number": "972-681-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "SANDHYA",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "RN, APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP125609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.