Individual provider Active NPI

Stephen M. Sanders Jr., P.A.

  • Physician Assistant
  • Oceanside, NY
National Provider Identifier
1457338410
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007812-1 Issued in NY
Practice address
1 Healthy Way
Oceanside, NY 11572-1551
Phone
(516) 632-3900
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 007812-1 NY Primary

Addresses

Primary practice location

1 Healthy Way
Oceanside, NY 11572-1551

Mailing address

PO Box 826223
Philadelphia, PA 19182-6223
Phone (866) 898-7142

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address STEPHEN.SANDERS@hca4.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100720000700 FL Practitioner - Physician Assistant 1658403092 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Pierce Orthopaedics LLCGroup PAC ID 2062515018, 19 clinicians

Practice addresses (Care Compare)

1700 S 23Rd St
HCA Florida Lawnwood Hospital
Fort Pierce, FL 34950-4803
Phone (772) 461-4000

2402 Frist Blvd
Fort Pierce, FL 34950-4838

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007812-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
FL-I Medical Services, LLC Physician Assistant CurrentSince May 12, 2012 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince May 12, 2012 Accepting new patients
Island Emergency Medical Services, P.C. Past Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: stephen.sanders@hca4.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1457338410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 826223",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191826223",
            "telephone_number": "866-898-7142",
            "fax_number": "770-237-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "STEPHEN",
        "middle_name": "M.",
        "name_suffix": "Jr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007812-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "STEPHEN.SANDERS@hca4.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1 Healthy Way",
            "city": "Oceanside",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115721551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.