NPIMap

Individual provider Active NPI

Sandy L Imperial, MD

  • Anatomic Pathology Physician
  • Ephrata, PA
National Provider Identifier
1194830356
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
MD061705L Issued in PA
Practice address
169 Martin Ave
Ephrata, PA 17522-1734
Phone
(717) 738-6408
Fax
(717) 738-6533
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X MD061705L PA Primary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X MD061705L PA

Addresses

Primary practice location

169 Martin Ave
Ephrata, PA 17522-1734

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 738-6114

Other practice location 1

37 N 5th St
Gettysburg, PA 17325-2004
Phone (717) 339-3125

Other identifiers 1

IdentifierTypeStateIssuer
01890365MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100719000091 PA Practitioner - Pathology 6305978933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ephrata Community HospitalGroup PAC ID 4981514445, 35 clinicians

Practice addresses (Care Compare)

169 Martin Ave
Ephrata, PA 17522-1734
Phone (717) 733-0311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD061705LPAMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ephrata Community Hospital Current Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

169 Martin Ave
#1002
Ephrata, PA 17522
Phone (717) 738-6818

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Organizations & group practices 3

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 11

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1194830356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-738-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MARTIN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221734",
            "telephone_number": "717-738-6408",
            "fax_number": "717-738-6533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173252004",
            "country_code": "US",
            "telephone_number": "717-339-3125",
            "fax_number": "717-334-3184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMPERIAL",
        "first_name": "SANDY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "PA",
            "license": "MD061705L",
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "PA",
            "license": "MD061705L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01890365",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

Verify at the official NPI Registry.