Individual provider Active NPI

Neela Wynn Sandal, M.D.

  • Family Medicine Physician
  • Lawrence, KS
National Provider Identifier
1508128810
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-38374 Issued in KS
Practice address
2323 Ridge CT
Lawrence, KS 66044
Phone
(785) 865-5300
NPI assigned
Jun 12, 2012
Last updated
Mar 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R73425 AZ
Family Medicine Physician 207Q00000X 04-38374 KS Primary

Addresses

Primary practice location

2323 Ridge CT
Lawrence, KS 66044

Mailing address

1108 Avalon
Lawrence, KS 66044
Phone (785) 979-2257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20240318001240 KS Order and Referring Only - Family PracticePractitioner - Family Practice 9931416641

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R73425AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Med PA PastSince Sep 1, 2015 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: neela.sandal.1@20969.direct.athenahealth.com

Organizations & group practices 2

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": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1508128810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 AVALON",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "66044",
            "telephone_number": "785-979-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 RIDGE CT",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "66044",
            "telephone_number": "785-865-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDAL",
        "first_name": "NEELA",
        "middle_name": "WYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R73425",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-38374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.