Individual provider Active NPI

Sandra K Menkedick, ARNP

  • Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1275599912
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRNCNP06618 Issued in OH
Practice address
234 Goodman St
Cincinnati, OH 45219-2364
Phone
(513) 475-8690
Fax
(513) 475-7257
NPI assigned
Apr 21, 2006
Last updated
Feb 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3591P KY
Nurse Practitioner 363L00000X APRNCNP06618 OH Primary
Licensed Practical Nurse 164W00000X 06618 OH

Addresses

Primary practice location

234 Goodman St
Cincinnati, OH 45219-2364

Mailing address

231 Albert Sabin Way
Cincinnati, OH 45267-2827

Other practice location 1

900 Medical Village Dr
Edgewood, KY 41017-3422
Phone (859) 331-0774

Other identifiers 1

IdentifierTypeStateIssuer
2364365MedicaidOH

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061109000622 OH Practitioner - Nurse Practitioner 9830197649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
65.97
Promoting interoperability
100
Improvement activities
40
Cost
74.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06618OHMDLicensed Practical Nurse
3591PKYMDNurse Practitioner
APRNCNP06618OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri State Neurology Clinic, Inc Past Accepting new patients
Your MD, LLC PastSince Aug 1, 2003 Accepting new patients
Tri-State Pulmonary Associates, Inc. PastSince Jun 1, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: smenkedick34085@direct.uchealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1275599912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 ALBERT SABIN WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452672827",
            "fax_number": "859-426-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODMAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192364",
            "telephone_number": "513-475-8690",
            "fax_number": "513-475-7257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Medical Village Dr",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173422",
            "country_code": "US",
            "telephone_number": "859-331-0774",
            "fax_number": "859-426-4051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENKEDICK",
        "first_name": "SANDRA",
        "middle_name": "K",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3591P",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRNCNP06618",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "06618",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2364365",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.