Individual provider Active NPI

Jason Sandler

  • Family Nurse Practitioner
  • Norwalk, CT
National Provider Identifier
1235507955
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6139 Issued in CT
Practice address
497 Westport Ave Ste 300
Norwalk, CT 06851-4411
Phone
(203) 852-3494
Fax
(203) 847-0013
NPI assigned
Sep 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6139 CT Primary

Addresses

Primary practice location

497 Westport Ave Ste 300
Norwalk, CT 06851-4411

Mailing address

497 Westport Ave
Norwalk, CT 06851-4411
Phone (203) 852-3494

Other identifiers 1

IdentifierTypeStateIssuer
008062105MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20151110001966 CT Practitioner - Nurse Practitioner 6103136734 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Danbury Hospital CurrentSince Mar 16, 2020 Accepting new patients
Danbury Hospital CurrentSince Mar 16, 2020 Accepting new patients
The Center for Advanced Pediatrics, P.C Past Accepting new patients

Locations

20 Germantown Rd
Danbury, CT 06810
Phone (203) 739-4820

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

Interoperability endpoints

  • Direct secure messaging: jason.sandler.1@16244.direct.athenahealth.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": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1235507955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 WESTPORT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514411",
            "telephone_number": "203-852-3494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 WESTPORT AVE STE 300",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514411",
            "telephone_number": "203-852-3494",
            "fax_number": "203-847-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDLER",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-11",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008062105",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.