NPIMap

Individual provider Active NPI

David Sandman

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1629296892
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036142209 Issued in IL
Practice address
676 N Saint Clair St Ste 800
Chicago, IL 60611-2978
Phone
(312) 695-6732
Fax
(312) 695-5645
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A107154 CA
Diagnostic Radiology Physician 2085R0202X 036142209 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 800
Chicago, IL 60611-2978

Mailing address

5767 W Century Blvd
Suite 200
Los Angeles, CA 90045-5631
Phone (310) 301-6800

Other practice location 1

10833 Le Conte Ave
Los Angeles, CA 90095-3075
Phone (310) 301-6800

Other identifiers 1

IdentifierTypeStateIssuer
00A1071540MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090817000355 CA Practitioner - Diagnostic Radiology 0840344438 Reassigns benefits to 1 organization
I20170314001347 IL Practitioner - Diagnostic Radiology 0840344438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loyola University of Chicago, Stritch School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

676 N Saint Clair St
Suite 800
Chicago, IL 60611-2978
Phone (312) 695-3775

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A107154CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Diagnostic Radiology CurrentSince Jun 9, 2015 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 1, 2023 Accepting new patients
Spectrum Imaging SC CurrentSince Mar 1, 2017 Accepting new patients
Northwestern Medical Faculty Foundation Diagnostic Radiology CurrentSince Jun 1, 2023 Accepting new patients
Instant Imaging LLC PastSince Apr 4, 2022 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
Scancare Diagnostics LLC PastSince Mar 1, 2017 Accepting new patients
Illinois Bone and Joint Institute LLC Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

250 Hospital Pkwy
San Jose, CA 95119
Phone (408) 972-6320

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

676 N Saint Clair St
Ste 800
Chicago, IL 60611
Phone (312) 695-5753

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 9

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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": "1698019200000",
    "number": "1629296892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 800",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112978",
            "telephone_number": "312-695-6732",
            "fax_number": "312-695-5645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10833 Le Conte Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900953075",
            "country_code": "US",
            "telephone_number": "310-301-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDMAN",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A107154",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036142209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A1071540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.