Sandi Angevine, M.D.
Individual provider Active NPI Pediatrics Physician · Anchorage, AK
NPI 1548488455 · NPPES record last updated Oct 3, 2014
Key facts
- NPI
- 1548488455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 6672 (AK)
- Practice address
- 4320 Diplomacy Dr
Anchorage, AK 99508-5925 - Phone
- (907) 729-8821
- NPI assigned
- Apr 23, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090629000061 | TX | Practitioner - Pediatric Medicine | 3870550767 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6672 | AK | MD | Pediatrics Physician |
| 9263 | HI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southcentral Foundation | Current | Accepting new patients | |
| Southcentral Foundation | Current | Accepting new patients | |
| Southcentral Foundation | Current | Accepting new patients | |
| Southcentral Foundation | Current | Accepting new patients | |
| Southcentral Foundation | Current |
Accepting new patients | |
| Alaska Native Tribal Health Consortium | Current |
Accepting new patients | |
| Southcentral Foundation | Current | Accepting new patients | |
| Southcentral Foundation | Current | Accepting new patients | |
| Southcentral Foundation | Past | Accepting new patients | |
| Southcentral Foundation | Past | Accepting new patients |
Locations
4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729
4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000
Interoperability endpoints
- sangevine@direct.scf.cc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 9263 | HI | |
| Pediatrics Physician | 208000000X | 6672 | AK | Yes |
Addresses
Primary practice location
4320 Diplomacy Dr
Anchorage, AK 99508-5925
Mailing address
4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone (907) 729-8821
Other providers in Anchorage, AK
- Angel of Hope Assisted Living Home, LLC
- Angel'S Love Alh, LLC
- Angeles Francisco LLC
- Christene Angell
- Angelus Alh LLC
- Blanca Esther Anglin
- Josephine Ngozi Ani
- Nelson H Aniel
- Elizabeth Grace Anker
- Anne L. Henry LPC, Counseling LLC
All providers in Anchorage, AK · Pediatrics Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.