Individual provider Active NPI

Jennifer Marie Sandoval, DNP, APRN, FNP-BC

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1316627334
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1138552 Issued in TX
Practice address
4450 Medical Dr Ste 550
San Antonio, TX 78229-3710
Phone
(210) 575-7268
Fax
(210) 575-8480
NPI assigned
Jul 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1138552 TX Primary
Registered Nurse 163W00000X 887477 TX

Addresses

Primary practice location

4450 Medical Dr Ste 550
San Antonio, TX 78229-3710

Mailing address

4450 Medical Dr Ste 550
San Antonio, TX 78229-3710
Phone (210) 575-7268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231103003486 TX Practitioner - Nurse Practitioner 6507213188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Physician Practices PLLCGroup PAC ID 8022171974, 176 clinicians

Practice addresses (Care Compare)

4450 Medical Dr
FL 1
San Antonio, TX 78229-3710
Phone (210) 575-3817

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.46 of 100Reported as group
Quality
71.92
Promoting interoperability
99
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
887477TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Physician Practices, PLLC CurrentSince Oct 30, 2023 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

4450 Medical Dr
Fl 1
San Antonio, TX 78229
Phone (210) 575-3817

111 Dallas St
Fl 4
San Antonio, TX 78205
Phone (210) 297-7195

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1316627334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 MEDICAL DR STE 550",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293710",
            "telephone_number": "210-575-7268",
            "fax_number": "210-575-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 MEDICAL DR STE 550",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293710",
            "telephone_number": "210-575-7268",
            "fax_number": "210-575-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1138552",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "887477",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.