Individual provider Active NPI

Sandra C. Truebe, MD

  • Pediatrics Physician
  • Manchester, NH
National Provider Identifier
1508856956
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
12058 Issued in NH
Practice address
275 Mammoth Rd
Suite 2
Manchester, NH 03109-4133
Phone
(603) 663-8300
Fax
(603) 663-8349
NPI assigned
Oct 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 12058 NH Primary

Addresses

Primary practice location

275 Mammoth Rd
Suite 2
Manchester, NH 03109-4133

Mailing address

275 Mammoth Rd
Suite 2
Manchester, NH 03109-4133
Phone (603) 663-8300

Other identifiers 6

IdentifierTypeStateIssuer
AA1997OtherNHHPHC
468780OtherNHTUFTS
437892OtherNHCIGNA
3539084OtherNHCIGNA
30203998MedicaidNH
30447YOtherNHANTHEM REFERRING RAN

Other names 1

  • Sandra C. Farkouh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20040412000659 NH Practitioner - Pediatric Medicine 9830183037 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12058NHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Physicians Network Pediatrics CurrentSince Mar 1, 2011 Accepting new patients
Elliot Physicians Network Past Accepting new patients

Locations

275 Mammoth Rd
Ste 2
Manchester, NH 03109
Phone (603) 663-8300

275 Mammoth Rd
Manchester, NH 03109
Phone (603) 663-8300

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

4 Elliot Way
Ste 105
Manchester, NH 03103
Phone (603) 626-5113

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

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.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508856956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MAMMOTH RD",
            "address_2": "SUITE 2",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031094133",
            "telephone_number": "603-663-8300",
            "fax_number": "603-663-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MAMMOTH RD",
            "address_2": "SUITE 2",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031094133",
            "telephone_number": "603-663-8300",
            "fax_number": "603-663-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUEBE",
        "first_name": "SANDRA",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "12058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "AA1997",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "468780",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "437892",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3539084",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30203998",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM REFERRING RAN",
            "identifier": "30447Y",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "FARKOUH",
            "middle_name": "C.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.