Individual provider Active NPI

Sandy Margaret Mueller-Brady, PA-C

  • Physician Assistant
  • Surf City, NC
National Provider Identifier
1205879657
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103730 Issued in NC
Practice address
13500 NC Highway 50
Surf City, NC 28445-7934
Phone
(910) 803-2025
Fax
(910) 803-2027
NPI assigned
Jun 14, 2006
Last updated
May 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103730 NC Primary

Addresses

Primary practice location

13500 NC Highway 50
Surf City, NC 28445-7934

Mailing address

13500 NC Highway 50
Surf City, NC 28445-7934
Phone (910) 803-2025

Other identifiers 1

IdentifierTypeStateIssuer
1154733707MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050801001190 NC Practitioner - Physician Assistant 5597707133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13500 NC Hwy 50
Suite 104
Surf City, NC 28445-7935
Phone (910) 803-2025

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
103730NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc Past Accepting new patients
Redimed Dekalb LLC Past Accepting new patients
Parkview Hospital, Inc. Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1205879657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 NC HIGHWAY 50",
            "city": "SURF CITY",
            "state": "NC",
            "postal_code": "284457934",
            "telephone_number": "910-803-2025",
            "fax_number": "910-803-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 NC HIGHWAY 50",
            "city": "SURF CITY",
            "state": "NC",
            "postal_code": "284457934",
            "telephone_number": "910-803-2025",
            "fax_number": "910-803-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER-BRADY",
        "first_name": "SANDY",
        "middle_name": "MARGARET",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154733707",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surf City, NC

Sources for this page

Verify at the official NPI Registry.