Sandrine Ndetah, APRN FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

356099 Issued in NY

Practice address

489 5TH Ave FL 3
New York, NY 10017-6145

Phone

(415) 658-6791

NPI assigned

Aug 3, 2021

Last updated

May 28, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, NY, NJ, NM, MA, ME, NH, MI, AZ9 enrollments

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 9

Specialty

Nurse Practitioner

Education

University of North Dakota School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Convenientmd - FFS UC LLCGroup PAC ID 5193186492, shared by 3 NPIs, 397 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts

State licenses

Practice roles

Locations

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.

• Lumina Care Medical NJ LLC

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1851118319

  NJ

  Medicare reassignment NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Ellsworth, ME
  • NPI 1780375220
  Medicare reassignment NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Worcester, MA
  • NPI 1790528628
  Medicare reassignment NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Nashua, NH
  • NPI 1851082291
  Medicare reassignment NPD
• Inpatient Rehabilitation Specialists, P.a.

  dba CareGenixTX

  • Physical Medicine & Rehabilitation Physician
  • Richardson, TX
  • NPI 1336190289
  Medicare reassignment NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  NH

  Medicare reassignment NPD
• Virtumed LLC

  • Internal Medicine Physician
  • Plano, TX
  • NPI 1235821943
  Medicare reassignment NPD
• Virtumed LLC

  • Physical Medicine & Rehabilitation Physician
  • Scottsdale, AZ
  • NPI 1710764477
  Medicare reassignment NPD
• Adherence Health Clinic PLLC

  • Nurse Practitioner
  • Rockwall, TX
  • NPI 1649115627
  NPD Authorized official
• Adherence Home Healthcare LLC

  • Home Health Agency
  • Fate, TX
  • NPI 1194412601
  NPD Authorized official
• Adherence Telehealth LLC

  • General Practice Physician
  • Rockwall, TX
  • NPI 1346104205
  NPD Authorized official
• Ivy Medical Group PLLC

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1700558798
  Medicare reassignment

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1639843634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176145",
            "telephone_number": "415-658-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDETAH",
        "first_name": "SANDRINE",
        "credential": "APRN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "113875-23",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "356099",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2391688",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corbyn Mbock Nchako, MD
• ND Line Inc
• Menimabasi Enameti Ndaessien, D.O
• William Massaquoi Ndama II, PRE-LMHC
• Borsso Ndao-Ceesay
• Sherah Janay Ndjongo, RN
• Era Erblin Ndreu, DDS
• Clarence Ndubisi
• Chinwe Victoria Nduka, RPA-C, MPAS
• Neal Blitz DPM PLLC

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.