Active NPI
Samantha Sardelli
- Case Manager/Care Coordinator
- Troy, MI
National Provider Identifier
1417367434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 6801092222
- Practice address
- 1250 Kirts Blvd
Ste. 300
Troy, MI 48084-4855 - Phone
- (248) 649-3739
- NPI assigned
- Apr 29, 2014
- Last updated
- Apr 29, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 6801092222 | MI | Primary |
Addresses
Primary practice location
1250 Kirts Blvd
Ste. 300
Troy, MI 48084-4855
Mailing address
1250 Kirts Blvd
Ste. 300
Troy, MI 48084-4855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801092222 | MI | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| On My Own of Michigan, Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Case Management Agency
- Troy, MI
- NPI 1548609654
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398729600000",
"number": "1417367434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 KIRTS BLVD",
"address_2": "STE. 300",
"city": "TROY",
"state": "MI",
"postal_code": "480844855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 KIRTS BLVD",
"address_2": "STE. 300",
"city": "TROY",
"state": "MI",
"postal_code": "480844855",
"telephone_number": "248-649-3739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARDELLI",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-29",
"last_updated": "2014-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "MI",
"license": "6801092222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.