Active NPI
Samantha Sandusky, APRN
- Nurse Practitioner
- Dayton, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN.CNP.021301
- Practice address
- 1 Wyoming St
Dayton, OH 45409-2722 - Phone
- (937) 208-8000
- NPI assigned
- Jun 14, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN.CNP.021301 | OH | Primary |
Addresses
Primary practice location
1 Wyoming St
Dayton, OH 45409-2722
Mailing address
1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
30 E Apple St
Suite 5254a
Dayton, OH 45409-2939
Phone (937) 208-4200
Hospital & facility affiliations
- Miami Valley Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.38 of 100
- Quality
- 66.25
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.69
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Carmel Health System | Current | Accepting new patients | |
| Premier Health Specialists Inc | Nurse Practitioner | Current | Accepting new patients |
| Mount Carmel Health System | Current | Accepting new patients | |
| Premier Health Specialists Inc | Current | Accepting new patients | |
| Premier Heart Associates, Inc | Past | Accepting new patients |
Locations
6150 E Broad St
Columbus, OH 43213
Phone (614) 546-4400
6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420
1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636
2300 Miami Valley Dr
Ste 550
Dayton, OH 45459
Phone (937) 438-7500
30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300
30 E Apple St
Ste 5254
Dayton, OH 45409
Phone (844) 277-2894
30 E Apple St
Ste 5254A
Dayton, OH 45409
9000 N Main St
Ste 238
Englewood, OH 45415
Phone (937) 832-0006
200 Medical Center Dr
Ste 325
Middletown, OH 45005
Phone (513) 705-4762
450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773
3130 N County Road 25A
Ste 114
Troy, OH 45373
Phone (937) 440-7665
477 Cooper Rd
Ste 300
Westerville, OH 43081
Phone (614) 898-8808
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Moraine, OH
- NPI 1194958223
Nurse Practitioner
-
- Internal Medicine Physician
- Columbus, OH
- NPI 1457617235
-
- General Acute Care Hospital
- Dublin, OH
- NPI 1710752183
-
- Foot & Ankle Surgery Podiatrist
- Dayton, OH
- NPI 1902211287
-
- Cardiovascular Disease Physician
- Beavercreek, OH
- NPI 1538188735
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dayton, OH
- NPI 1073688354
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684108800000",
"number": "1215467105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 WYOMING ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092722",
"telephone_number": "937-208-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 WYOMING ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092722",
"telephone_number": "937-208-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDUSKY",
"first_name": "SAMANTHA",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-14",
"last_updated": "2023-05-15",
"certification_date": "2023-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "APRN.CNP.021301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.