Individual provider Active NPI

Sandra Michal Hadenfeld, ARNP, MN, FNP-C

  • Nurse Practitioner
  • Salem, OR
National Provider Identifier
1710123054
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60065168 Issued in WA
Practice address
1793 13TH St SE
Salem, OR 97302-2541
Phone
(503) 362-8385
Fax
(503) 362-8435
NPI assigned
Dec 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60065168 WA Primary

Addresses

Primary practice location

1793 13TH St SE
Salem, OR 97302-2541

Mailing address

1793 13TH St SE
Salem, OR 97302-2541
Phone (503) 362-8385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20090126000171 WA Practitioner - Nurse Practitioner 7113081845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as group
Promoting interoperability
89
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60065168WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Falls Dermatology, LLC Nurse Practitioner CurrentSince Jul 1, 2015 Accepting new patients
Silver Falls Dermatology, LLC CurrentSince Jul 1, 2015 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

1390 Waverly Dr SE
Albany, OR 97322
Phone (541) 967-8385

920 Country Club Rd
Ste 140A
Eugene, OR 97401
Phone (665) 993-3768

831 NW Council Dr
Ste 301
Gresham, OR 97030
Phone (503) 661-2577

375 SE Norton Ln
Ste C
McMinnville, OR 97128
Phone (503) 472-8162

3132 State St
Ste 110
Medford, OR 97504
Phone (541) 732-1686

1010 SW Coast Hwy
Ste 201
Newport, OR 97365
Phone (541) 257-6393

1793 13th St SE
Salem, OR 97302
Phone 50336283851283

1430 Commercial St SE
Salem, OR 97302
Phone (503) 362-9033

1515 116th Ave NE
Ste 307
Bellevue, WA 98004
Phone (425) 999-2628

1106 Douglas St
Ste F
Longview, WA 98632
Phone (360) 636-4500

1338 Commerce Ave
Ste 106
Longview, WA 98632
Phone (971) 915-8587

19917 7th Ave NE
Ste 101
Poulsbo, WA 98370
Phone (360) 824-5474

19917 7th Ave NE
Ste 203
Poulsbo, WA 98370
Phone (360) 824-5474

Organizations & group practices 3

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": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1710123054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1793 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022541",
            "telephone_number": "503-362-8385",
            "fax_number": "503-362-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1793 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022541",
            "telephone_number": "503-362-8385",
            "fax_number": "503-362-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADENFELD",
        "first_name": "SANDRA",
        "middle_name": "MICHAL",
        "credential": "ARNP, MN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-16",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60065168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.