Active NPI
Sandhya Ganesan
- Student in an Organized Health Care Education/Training Program
- Stony Brook, NY
National Provider Identifier
1124822549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 101 Nicolls Rd
Stony Brook, NY 11794-0001 - Phone
- (516) 721-7006
- NPI assigned
- Apr 3, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
101 Nicolls Rd
Stony Brook, NY 11794-0001
Mailing address
174 Devonshire Dr
New Hyde Park, NY 11040-3633
Phone (516) 721-7006
Other practice location 1
16 S Eutaw St Ste 500
Baltimore, MD 21201-1619
Phone (667) 214-2392
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783555200000",
"number": "1124822549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 DEVONSHIRE DR",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110403633",
"telephone_number": "516-721-7006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 NICOLLS RD",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117940001",
"telephone_number": "516-721-7006"
}
],
"practiceLocations": [
{
"address_1": "16 S Eutaw St Ste 500",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212011619",
"country_code": "US",
"telephone_number": "667-214-2392",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GANESAN",
"first_name": "SANDHYA",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-04-03",
"last_updated": "2026-07-09",
"certification_date": "2026-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.