Individual provider Active NPI

Sara Nandolia, DO

  • Pediatric Gastroenterology Physician
  • Tyler, TX
National Provider Identifier
1487275475
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
U2584 Issued in TX
Practice address
1120 E Front St
Tyler, TX 75702-8414
Phone
(903) 606-3630
NPI assigned
Apr 30, 2020
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X H0096933 MD
Pediatric Gastroenterology Physician 2080P0206X U2584 TX Primary

Addresses

Primary practice location

1120 E Front St
Tyler, TX 75702-8414

Mailing address

101 W Cross St Apt 665
Baltimore, MD 21230-3692
Phone (443) 927-3360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20240410003943 MD Practitioner - Pediatric Medicine 5698196913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
U2584TXMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Mar 1, 2024 Accepting new patients
Johns Hopkins University CurrentSince Mar 1, 2024 Accepting new patients
Johns Hopkins University Current Accepting new patients
Magella Medical Associates Billing, Inc. Past Accepting new patients
Christus Trinity Clinic Texas Past Accepting new patients

Locations

601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: snandolia1117823@direct.hopkinsmedicine.org

Organizations & group practices 5

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": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1487275475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W CROSS ST APT 665",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212303692",
            "telephone_number": "443-927-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E FRONT ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028414",
            "telephone_number": "903-606-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDOLIA",
        "first_name": "SARA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-30",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MD",
            "license": "H0096933",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "U2584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.