Individual provider Active NPI

Andrea Michelle Sandifer, O.D.

  • Optometrist
  • Louisville, KY
National Provider Identifier
1447834080
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2219DT Issued in KY
Practice address
4000 Poplar Level Rd
Louisville, KY 40213-1524
Phone
(502) 813-8928
Fax
(502) 456-9121
NPI assigned
May 10, 2021
Last updated
May 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2219DT KY Primary

Addresses

Primary practice location

4000 Poplar Level Rd
Louisville, KY 40213-1524

Mailing address

4000 Poplar Level Rd
Louisville, KY 40213-1524
Phone (502) 813-8928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211022000788 KY Practitioner - Optometry 7012305147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2525 Elizabethtown Rd
Leitchfield, KY 42754-9120
Phone (270) 259-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Louisville Optometric Centers III, PSC Optometrist CurrentSince Sep 1, 2021 Accepting new patients
Louisville Optometric Centers III, PSC CurrentSince Sep 1, 2021 Accepting new patients
Louisville Optometric Centers, III PSC Optometrist Past Accepting new patients

Locations

109 S Walters Ave
Hodgenville, KY 42748
Phone (270) 358-4157

2525 Elizabethtown Rd
Leitchfield, KY 42754
Phone (270) 259-2020

4000 Poplar Level Rd
Louisville, KY 40213
Phone (502) 456-1004

815 Main St
Munfordville, KY 42765
Phone (270) 524-5444

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": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1447834080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 POPLAR LEVEL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402131524",
            "telephone_number": "502-813-8928",
            "fax_number": "502-456-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 POPLAR LEVEL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402131524",
            "telephone_number": "502-813-8928",
            "fax_number": "502-456-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDIFER",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2219DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.