Justin K Sandefur

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP139467 Issued in TX

Practice address

4900 Mueller Blvd
Austin, TX 78723-3079

Phone

(512) 324-0515

NPI assigned

Oct 28, 2018

Last updated

Mar 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Texas Children's Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Texas Children's Hospital

  dba Texas Children's Hospital North Austin Campus

  • Children's Hospital
  • Austin, TX
  • NPI 1194507947
  NPD (past)
• Texas Childrens Hospital

  dba Pediatric Pathology Consultants

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
  • NPI 1285403642
  NPD (past)

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

{
    "created_epoch": "1540684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1497222400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 PAGE ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787235484",
            "telephone_number": "512-748-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233079",
            "telephone_number": "512-324-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDEFUR",
        "first_name": "JUSTIN",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-28",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP139467",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP139467",
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "AP139467",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Sanchez
• Sanctuary Counseling, PLLC
• John Franklin Sandbach, MD
• Thomas M Sandberg, DC
• Sandeep B. Patel, D.D.S., P.a. (Onion Creek Family Dentistry)
• Hans Michael Sander, MD
• Amy Elizabeth Sanders, OTR
• Angela Elizabeth Sanders, OTR
• Barbara Louise Sanders, PT, PHD, SCS
• Geremy Lee Sanders, MD

• Pediatric Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.