Individual provider Active NPI

Sandra J. Federo, CRNP

  • Family Nurse Practitioner
  • Cranberry Township, PA
National Provider Identifier
1447382270
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP004337B Issued in PA
Practice address
1181 Freedom Rd
Cranberry Township, PA 16066-4913
Phone
(724) 742-1888
NPI assigned
Mar 9, 2007
Last updated
Sep 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP004337B PA Primary

Addresses

Primary practice location

1181 Freedom Rd
Cranberry Township, PA 16066-4913

Mailing address

250 Deer Run Rd
Plymouth, PA 18651-4405
Phone (570) 779-4892

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20141218002118 PA Practitioner - Nurse Practitioner 8820311012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP004337BPAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Misericordia University Speech-Language and Hearing Center Current Accepting new patients
Misericordia University Family Current Accepting new patients
Lifesavers CRNP LLC Family CurrentSince Jul 1, 2024 Accepting new patients

Locations

301 Lake St
Dallas, PA 18612
Phone (570) 674-6954

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1447382270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 DEER RUN RD",
            "city": "PLYMOUTH",
            "state": "PA",
            "postal_code": "186514405",
            "telephone_number": "570-779-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 FREEDOM RD",
            "city": "CRANBERRY TOWNSHIP",
            "state": "PA",
            "postal_code": "160664913",
            "telephone_number": "724-742-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDERO",
        "first_name": "SANDRA",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP004337B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranberry Township, PA

Sources for this page

Verify at the official NPI Registry.