Individual provider Active NPI

Ian Sandy, M.D.

  • Anesthesiology Physician
  • Upland, CA
National Provider Identifier
1366470783
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A63179 Issued in CA
Practice address
999 San Bernardino Rd
Upland, CA 91786-4920
Phone
(909) 920-4848
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A63179 CA Primary

Addresses

Primary practice location

999 San Bernardino Rd
Upland, CA 91786-4920

Mailing address

PO Box 148
Claremont, CA 91711-0148
Phone (909) 985-2112

Other identifiers 1

IdentifierTypeStateIssuer
00A631790MedicaidCA

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
I20100910000640 CA Practitioner - Anesthesiology 0042335218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loma Linda University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Anesthesia Medical Group IncGroup PAC ID 6103728407, 185 clinicians

Practice addresses (Care Compare)

999 San Bernardino Rd
Upland, CA 91786-4920
Phone (909) 985-2811

Hospital & facility affiliations

  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A63179CAMDAnesthesiology Physician

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 1

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366470783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 148",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917110148",
            "telephone_number": "909-985-2112",
            "fax_number": "909-985-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 SAN BERNARDINO RD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864920",
            "telephone_number": "909-920-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDY",
        "first_name": "IAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A63179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A631790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.