Individual provider Active NPI

Terry L Sanderfer, M.D.

  • Surgery Physician
  • Corona, CA
National Provider Identifier
1235102401
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G397360 Issued in CA
Practice address
2250 S Main St Ste 106
Corona, CA 92882-2501
Phone
(951) 371-2703
Fax
(951) 371-9348
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G397360 CA Primary

Addresses

Primary practice location

2250 S Main St Ste 106
Corona, CA 92882-2501

Mailing address

1901 Town and Country Dr Ste 104
Norco, CA 92860-3611
Phone (951) 808-6250

Other practice location 1

2250 S Main St Ste 208
Corona, CA 92882-2507
Phone (951) 271-4161

Other identifiers 1

IdentifierTypeStateIssuer
00G397360MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041223000128 CA Practitioner - General Surgery 4587622485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of California, Irvine, California College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citrus Valley Medical Associates IncGroup PAC ID 0446329932, 14 clinicians

Practice addresses (Care Compare)

2250 S Main St
Suite 106
Corona, CA 92882-2501
Phone (951) 371-2703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G397360CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Citrus Valley Medical Associates, Inc. CurrentSince Mar 19, 2018 Accepting new patients
Uhs Corona Inc Past Accepting new patients
Integrated Medical Center of Corona Inc. PastSince Apr 1, 2015 Accepting new patients

Locations

2250 S Main St
Ste 106
Corona, CA 92882
Phone (951) 371-2703

2250 S Main St
Ste 208
Corona, CA 92882
Phone (951) 271-4161

1901 Town and Country Dr
Ste 104
Norco, CA 92860
Phone (951) 737-8141

940 N Haven Ave
Ste 18025
Ontario, CA 91764

Interoperability endpoints

  • Direct secure messaging: terry.sanderfer.p1@direct.cvma.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1235102401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 TOWN AND COUNTRY DR STE 104",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603611",
            "telephone_number": "951-808-6250",
            "fax_number": "951-738-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST STE 106",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822501",
            "telephone_number": "951-371-2703",
            "fax_number": "951-371-9348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2250 S Main St Ste 208",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928822507",
            "country_code": "US",
            "telephone_number": "951-271-4161",
            "fax_number": "951-737-9907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERFER",
        "first_name": "TERRY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G397360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G397360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.