Individual provider Active NPI

M. Craig Sandberg, M.D.

  • Psychiatry Physician
  • Bath, NY
National Provider Identifier
1396831491
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
199377 Issued in NY
Practice address
76 Veterans Ave
Bath VA Medical Center
Bath, NY 14810-0810
Phone
(607) 664-4300
Fax
(607) 664-4320
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

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
Psychiatry Physician 2084P0800X 199377 NY Primary

Addresses

Primary practice location

76 Veterans Ave
Bath VA Medical Center
Bath, NY 14810-0810

Mailing address

76 Veterans Ave
Bath VA Medical Center
Bath, NY 14810-0810
Phone (607) 664-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396831491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 VETERANS AVE",
            "address_2": "BATH VA MEDICAL CENTER",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148100810",
            "telephone_number": "607-664-4300",
            "fax_number": "607-664-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 VETERANS AVE",
            "address_2": "BATH VA MEDICAL CENTER",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148100810",
            "telephone_number": "607-664-4300",
            "fax_number": "607-664-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDBERG",
        "first_name": "M. CRAIG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "199377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

Verify at the official NPI Registry.