Individual provider Active NPI

Sandra Marie Dave, FNPC

  • Family Nurse Practitioner
  • New Rochelle, NY
National Provider Identifier
1720070733
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F333498 Issued in NY
Practice address
110 Lockwood Ave
Suite 202
New Rochelle, NY 10801-5028
Phone
(914) 633-7200
Fax
(914) 633-7217
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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 F333498 NY Primary

Addresses

Primary practice location

110 Lockwood Ave
Suite 202
New Rochelle, NY 10801-5028

Mailing address

110 Lockwood Ave
Suite 202
New Rochelle, NY 10801-5028
Phone (914) 633-7200

Other identifiers 3

IdentifierTypeStateIssuer
2200986OtherUNITED HEALTHCARE
P2736693OtherOXFORD
02292942MedicaidNY

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
I20040720000883 NY Practitioner - Nurse Practitioner 8325028517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dave Family Medical Services PCGroup PAC ID 7012806730, 2 clinicians

Practice addresses (Care Compare)

110 Lockwood Ave
New Rochelle, NY 10801-5011
Phone (914) 633-7200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F333498NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dave Family Medical Services PC CurrentSince Jan 1, 2013 Accepting new patients
Paragon Emergency Medical Care, PC Past Accepting new patients

Locations

110 Lockwood Ave
Ste 202
New Rochelle, NY 10801
Phone (914) 633-7200

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1720070733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LOCKWOOD AVE",
            "address_2": "SUITE 202",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015028",
            "telephone_number": "914-633-7200",
            "fax_number": "914-633-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LOCKWOOD AVE",
            "address_2": "SUITE 202",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015028",
            "telephone_number": "914-633-7200",
            "fax_number": "914-633-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "SANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2200986",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2736693",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02292942",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

Verify at the official NPI Registry.