Individual provider Active NPI

Holly Sandberg, PA-C

  • Physician Assistant
  • Plano, TX
National Provider Identifier
1407626153
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17368 Issued in TX
Practice address
3901 W 15TH St
Plano, TX 75075-7738
Phone
(814) 969-1597
NPI assigned
Jan 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17368 TX Primary

Addresses

Primary practice location

3901 W 15TH St
Plano, TX 75075-7738

Mailing address

5001 State Highway 114 Apt 2309
Northlake, TX 76262-2267
Phone (814) 969-1597

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
I20240228003928 TX Practitioner - Physician Assistant 5698110708 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Legacy Urgent Care PAGroup PAC ID 3072679828, 157 clinicians

Practice addresses (Care Compare)

211 W Frontier Pkwy
Prosper, TX 75078-3751
Phone (469) 868-9100

330 S Denton Tap Rd
Coppell, TX 75019-3207
Phone (469) 312-7777

9205 Legacy Dr
Frisco, TX 75033-6750
Phone (972) 625-6020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17368TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frisco Emergency Medicine Associates, PA CurrentSince Jan 31, 2026 Accepting new patients
Questcare Medical Services, PLLC Physician Assistant CurrentSince Feb 9, 2024 Accepting new patients

Locations

330 S Denton Tap Rd
Coppell, TX 75019
Phone (469) 312-7777

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

9205 Legacy Dr
Frisco, TX 75033
Phone (972) 625-6020

2810 S Hardin Blvd
Ste 100
McKinney, TX 75072
Phone (972) 548-7277

8950 N Tarrant Pkwy
North Richlnd Hls, TX 76182
Phone (817) 281-7277

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1407626153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 STATE HIGHWAY 114 APT 2309",
            "city": "NORTHLAKE",
            "state": "TX",
            "postal_code": "762622267",
            "telephone_number": "814-969-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 W 15TH ST",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757738",
            "telephone_number": "814-969-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDBERG",
        "first_name": "HOLLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.