Individual provider Active NPI

Marisa Sandera, M.D.

  • Medical Oncology Physician
  • Boerne, TX
National Provider Identifier
1508828971
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
M0556 Issued in TX
Practice address
134 Menger SPGS
Suite 1120
Boerne, TX 78006-7218
Phone
(210) 593-5700
Fax
(210) 593-5992
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X M0556 TX Primary

Addresses

Primary practice location

134 Menger SPGS
Suite 1120
Boerne, TX 78006-7218

Mailing address

134 Menger SPGS
Suite 1120
Boerne, TX 78006-7218
Phone (210) 593-5700

Other identifiers 5

IdentifierTypeStateIssuer
1745390-02OtherTXCSHCN
P00269397OtherTXRR/MEDICARE
1745390-03MedicaidTX
1745390-01MedicaidTX
8S1845OtherTXBLUE SHIELD

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050816001292 TX Practitioner - Medical OncologyPractitioner - Internal Medicine 0749210060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Internal Medicine
Education
University of Texas Medical School at San Antonio, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1420 River Rd
Suite 200
Boerne, TX 78006-1994
Phone (210) 593-5700

155 E Sonterra Blvd
Suite 200
San Antonio, TX 78258-3989
Phone (210) 593-5700

4383 Medical Dr
San Antonio, TX 78229-3307
Phone (210) 593-5700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.7 of 100Reported as group
Quality
62.04
Promoting interoperability
90
Improvement activities
40
Cost
84.41

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Oncology and Hematology, PLLC CurrentSince Aug 1, 2008 Accepting new patients
South Texas Oncology and Hematology, PLLC CurrentSince Aug 1, 2008 Accepting new patients

Locations

1420 River Rd
Ste 200
Boerne, TX 78006
Phone (830) 816-2552

134 Menger Spgs
Ste 1120
Boerne, TX 78006
Phone (210) 874-3359

5715 Rogers Rd
San Antonio, TX 78251

502 Madison Oak Dr
Ste 120
San Antonio, TX 78258

155 E Sonterra Blvd
Ste 200
San Antonio, TX 78258
Phone (210) 593-5875

4383 Medical Dr
San Antonio, TX 78229
Phone (210) 593-2584

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1508828971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 MENGER SPGS",
            "address_2": "SUITE 1120",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780067218",
            "telephone_number": "210-593-5700",
            "fax_number": "210-593-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 MENGER SPGS",
            "address_2": "SUITE 1120",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780067218",
            "telephone_number": "210-593-5700",
            "fax_number": "210-593-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERA",
        "first_name": "MARISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "TX",
            "license": "M0556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "1745390-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "P00269397",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1745390-03",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1745390-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "8S1845",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.