Fareesa Shuja Sandoval, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

P8078 Issued in TX

Practice address

1760 Round Rock Ave
Round Rock, TX 78681-4217

Phone

(512) 583-3376

Fax

(512) 540-8175

NPI assigned

Jun 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Fareesa Shuja Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Baylor College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Westlake Dermatology PAGroup PAC ID 6305817230, 52 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Westlake Dermatology PA

  • Dermatology Physician
  • Austin, TX
  • NPI 1518939347
  Medicare reassignment Care Compare group NPD
• Westlake Dermatology, PA

  • Dermatology Physician
  • Alamo Heights, TX
  • NPI 1265086045
  NPD
• Westlake Dermatology, PA

  • Dermatology Physician
  • Lakeway, TX
  • NPI 1891029476
  NPD

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

{
    "created_epoch": "1276992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1447571849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 ROUND ROCK AVE",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814217",
            "telephone_number": "512-583-3376",
            "fax_number": "512-666-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 ROUND ROCK AVE",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814217",
            "telephone_number": "512-583-3376",
            "fax_number": "512-540-8175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "FAREESA",
        "middle_name": "SHUJA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-20",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P8078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAREESA",
            "last_name": "SHUJA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Servando Sanchez Jr., MD
• Sofia Sanchez
• Isadora Sande Mathias, MD
• Sandeep G. Mistry, MD, PA
• Megan Sanders, RN, IBCLC
• India Sandoval, RBT
• Sandra Aguilar, PLLC
• Christina Mary Sanner, PH.D.
• Jeffrey Sanschagrin, DPT
• Maria Teresa Santana, DDS

• Dermatology Physician in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.