Sandrock Podiatry LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

SANDROCK PODIATRY LLC

Practice address

4707 Rio St
Farmington, NM 87402-5323

Phone

(505) 787-9035

NPI assigned

Oct 6, 2023

Organization subpart

No

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

Authorized official

Name

Eric Haag, MDNPI 1659524643

Title

Owner/Podiatrist

Phone

(505) 787-9035

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric C Haag, DPM

  • Podiatrist
  • Farmington, NM
  • NPI 1659524643

  NM, Podiatrist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1124809066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4707 RIO ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874025323",
            "telephone_number": "505-787-9003",
            "fax_number": "505-291-3293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 RIO ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874025323",
            "telephone_number": "505-787-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDROCK PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-06",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "HAAG",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "505-787-9035",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM-GROUP MEDICARE PTAN",
            "identifier": "6N8581",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74122355",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andy Lorenzo Sandoval, D.C.
• Jackie Faith Sandoval, LMSW
• Patricia Sandoval, BSN RN
• Phyllis M Sandoval
• Valerie Sandoval
• Dee Ann Sands, LPCC, NCC, CADS
• Chandan Singh Sapkota, MD
• Nina Patrice Sasaki, OTRL
• Charlene Saunders
• Aaron Kay Sawyer

• Podiatrist in Farmington, NM
• Providers in Farmington, NM by specialty
• Podiatrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.