Individual provider Active NPI

Sandra Wassinger, FNP

  • Family Nurse Practitioner
  • Spencerport, NY
National Provider Identifier
1639617178
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
341315 Issued in NY
Practice address
20 Sias LN
Spencerport, NY 14559-1908
Phone
(585) 545-0501
NPI assigned
Feb 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 341315 NY Primary

Addresses

Primary practice location

20 Sias LN
Spencerport, NY 14559-1908

Mailing address

20 Sias LN
Spencerport, NY 14559-1908
Phone (585) 545-0501

Other names 1

  • Ms. Sandra Kovacevic Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241209003486 NY Practitioner - Nurse Practitioner 2365978772 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown East Medical Services, PC CurrentSince Dec 22, 2024 Accepting new patients

Locations

15 Fishers Rd
Ste 114
Pittsford, NY 14534
Phone (585) 376-7738

113 Seaboard Ln
Ste 200B
Franklin, TN 37067
Phone (615) 721-7020

Interoperability endpoints

  • Direct secure messaging: sandra.wassinger.1@29290.direct.athenahealth.com

Organizations & group practices 1

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": "1486166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1639617178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SIAS LN",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145591908",
            "telephone_number": "585-545-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SIAS LN",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145591908",
            "telephone_number": "585-545-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSINGER",
        "first_name": "SANDRA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-04",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "KOVACEVIC",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spencerport, NY

Sources for this page

Verify at the official NPI Registry.