Individual provider Active NPI

Diana Sandmeyer

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1508493966
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD481695 Issued in PA
Practice address
8556 Bustleton Ave
Philadelphia, PA 19152-1218
Phone
(215) 698-9200
Fax
(215) 698-0816
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD481695 PA Primary

Addresses

Primary practice location

8556 Bustleton Ave
Philadelphia, PA 19152-1218

Mailing address

101 E Olney Ave Ste 400
Philadelphia, PA 19120-2470
Phone (215) 698-9200

Other practice location 1

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 741-2426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
New York University School of Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

401
73 Suite 320
Marlton, NJ 08053-3426

401
73 Suite 320
Marlton, NJ 08053-3433

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD481695PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Community Health Associates, Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1508493966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE STE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202470",
            "telephone_number": "215-698-9200",
            "fax_number": "215-456-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8556 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191521218",
            "telephone_number": "215-698-9200",
            "fax_number": "215-698-0816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-741-2426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDMEYER",
        "first_name": "DIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD481695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.