Individual provider Active NPI

Jessie Lynne Sandlin, MD

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1578723243
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
S9219 Issued in TX
Practice address
8706 Fredericksburg Rd
Ste 104
San Antonio, TX 78240-1293
Phone
(210) 764-6819
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 25277 NE
Anesthesiology Physician 207L00000X S9219 TX Primary
Anesthesiology Physician 207L00000X ME125045 FL

Addresses

Primary practice location

8706 Fredericksburg Rd
Ste 104
San Antonio, TX 78240-1293

Mailing address

8706 Fredericksburg Rd
Ste 104
San Antonio, TX 78240-1293

Other names 1

  • Dr. Jessie Lynne Cassada Former name

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
I20210112002012 TX Practitioner - Anesthesiology 0840428686 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME125045FLMDAnesthesiology Physician
S9219TXMDAnesthesiology Physician
25277NEMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Anesthesia Team PLLC Anesthesiology CurrentSince Feb 23, 2021 Accepting new patients
San Antonio Childrens Surgical CurrentSince Jan 11, 2021 Accepting new patients

Locations

5744 Lyndon B Johnson Fwy
Ste 200
Dallas, TX 75240
Phone (214) 273-2648

3055 Bardin Rd
Ste 400
Grand Prairie, TX 75052
Phone (214) 412-1500

8545 Gulf Fwy
Houston, TX 77017
Phone (713) 941-7737

6 Lakeway Centre Ct
Lakeway, TX 78734
Phone (737) 787-3002

8706 Fredericksburg Rd
Ste 104
San Antonio, TX 78240
Phone (210) 714-2488

9709 Lakeside Blvd
Ste 350
Spring, TX 77381

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1578723243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8706 FREDERICKSBURG RD",
            "address_2": "STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8706 FREDERICKSBURG RD",
            "address_2": "STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401293",
            "telephone_number": "210-764-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDLIN",
        "first_name": "JESSIE",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "25277",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "S9219",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME125045",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIE",
            "last_name": "CASSADA",
            "middle_name": "LYNNE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.