Active NPI
Jeremy Sandberg, DO
- Anesthesiology Physician
- Dayton, OH
National Provider Identifier
1457094807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 2026021219
- Practice address
- 405 W Grand Ave
Dayton, OH 45405-7538 - Phone
- (937) 723-3245
- NPI assigned
- Apr 14, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 2026021219 | MO | Primary |
Addresses
Primary practice location
405 W Grand Ave
Dayton, OH 45405-7538
Mailing address
405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 723-3245
Other practice location 1
1100 N Kentucky Ave
West Plains, MO 65775-2029
Phone (417) 256-9111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Touro Un Col of Osteopathic Medicine, Henderson, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
326 S Mount Auburn Rd
Cape Girardeau, MO 63703-4907
405 W Grand Ave
Dayton, OH 45405-7538
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2026021219 | MO | MD | Anesthesiology Physician |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780012800000",
"number": "1457094807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 W GRAND AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454057538",
"telephone_number": "937-723-3245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 W GRAND AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454057538",
"telephone_number": "937-723-3245"
}
],
"practiceLocations": [
{
"address_1": "1100 N Kentucky Ave",
"address_purpose": "LOCATION",
"city": "West Plains",
"state": "MO",
"postal_code": "657752029",
"country_code": "US",
"telephone_number": "417-256-9111",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANDBERG",
"first_name": "JEREMY",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-14",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MO",
"license": "2026021219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.