NPIMap

Individual provider Active NPI

Sandi Angevine, M.D.

  • Pediatrics Physician
  • Anchorage, AK
National Provider Identifier
1548488455
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
6672 Issued in AK
Practice address
4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone
(907) 729-8821
NPI assigned
Apr 23, 2007
Last updated
Oct 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9263 HI
Pediatrics Physician 208000000X 6672 AK Primary

Addresses

Primary practice location

4320 Diplomacy Dr
Anchorage, AK 99508-5925

Mailing address

4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone (907) 729-8821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090629000061 TX Practitioner - Pediatric Medicine 3870550767 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6672AKMDPediatrics Physician
9263HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Feb 20, 2011 Accepting new patients
Southcentral Foundation CurrentSince May 17, 2009 Accepting new patients
Southcentral Foundation 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

  • Direct secure messaging: sangevine@direct.scf.cc

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1548488455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085925",
            "telephone_number": "907-729-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085925",
            "telephone_number": "907-729-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGEVINE",
        "first_name": "SANDI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "9263",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AK",
            "license": "6672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.