Sandra D. Brewer, CRNP
Individual provider Active NPI Nurse Practitioner · Sayre, PA
NPI 1386613552 · NPPES record last updated Mar 5, 2021
Key facts
- NPI
- 1386613552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- F304302-1 (NY)
- Practice address
- 1 Guthrie SQ
Sayre, PA 18840-1625 - Phone
- (570) 888-5858
- NPI assigned
- Mar 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060329000696 | NY | Practitioner - Nurse Practitioner | 7719995950 | Reassigns benefits to 1 organization |
| I20060426000264 | PA | Practitioner - Nurse Practitioner | 7719995950 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F304302-1 | NY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guthrie Medical Group, P.C. | Current |
Accepting new patients | |
| Guthrie Medical Group, P.C. | Current | Accepting new patients | |
| Guthrie Medical Group, P.C. | Current | Accepting new patients | |
| Guthrie Medical Group, P.C. | Current |
Accepting new patients | |
| Guthrie Medical Group, P.C. | Current |
Accepting new patients | |
| Guthrie Medical Group PC | Past | Accepting new patients | |
| Guthrie Clinic LTD | Past | Accepting new patients |
Locations
130 Center Way
Corning, NY 14830
Phone (607) 936-9971
1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | SP004945C | PA | |
| Nurse Practitioner | 363L00000X | F304302-1 | NY | Yes |
Addresses
Primary practice location
1 Guthrie SQ
Sayre, PA 18840-1625
Mailing address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CC9269 | Other | PA | RR MEDICARE GROUP |
| P00316311 | Other | PA | RR MEDICARE PIN |
| P00319054 | Other | NY | RR MEDICARE PIN |
| GU039853 | Other | PA | MEDICARE GROUP |
| 02703506 | Medicaid | NY | |
| CC8362 | Other | NY | RR MEDICARE GROUP |
Other names
- Ms. Sandra E. Brunk
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sbrewer5180@direct-guthrie.org | Direct | |
| Direct Messaging Address | sbrewer5180@direct-guthrie.org | Direct |
Other providers in Sayre, PA
- Richard Perry Bradstreet
- Adrienne M. Bragg
- Lisa Braund
- Amanda Ryan Bray-Hooker
- Adam Breslin
- Eric Bridenbaugh
- Mark C Bristol
- Avril E. Brown
- Daniel Joseph Brown
- Madelen Brunner
All providers in Sayre, PA · Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.