Individual provider Active NPI

Joyce Dandreo Sanderson, PA-C

  • Surgical Physician Assistant
  • Boston, MA
National Provider Identifier
1528232113
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2484 Issued in MA
Practice address
750 Washington St
Floating Hospital, RM 401
Boston, MA 02111-1526
Phone
(617) 636-7920
Fax
(617) 636-9107
NPI assigned
Apr 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2484 MA Primary

Addresses

Primary practice location

750 Washington St
Floating Hospital, RM 401
Boston, MA 02111-1526

Mailing address

750 Washington St
Floating Hospital, RM 401
Boston, MA 02111-1526
Phone (617) 636-7920

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2484MAMDPhysical Therapy Assistant

Interoperability endpoints

  • Direct secure messaging: jsanderson24004@tuftsmedicine.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1528232113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 WASHINGTON ST",
            "address_2": "FLOATING HOSPITAL, RM 401",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111526",
            "telephone_number": "617-636-7920",
            "fax_number": "617-636-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WASHINGTON ST",
            "address_2": "FLOATING HOSPITAL, RM 401",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111526",
            "telephone_number": "617-636-7920",
            "fax_number": "617-636-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "JOYCE",
        "middle_name": "DANDREO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "2484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.