Stefanie N Sanderson, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA04819 Issued in TX

Practice address

1545 E Southlake Blvd
Suite 100
Southlake, TX 76092-6422

Phone

(817) 442-9300

Fax

(817) 796-0763

NPI assigned

Jun 9, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Hospital Southlake Hospital, Southlake, TX, CCN 450888

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssanderson435261@direct.texashealth.org

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.

• S4 Sand PLLC

  • Surgical Physician Assistant
  • Roanoke, TX
  • NPI 1679013536
  Medicare reassignment Authorized official
• Spine Team Texas PA

  • Neurological Surgery Physician
  • Southlake, TX
  • NPI 1629082995
  Medicare reassignment NPD
• Texas Health Back Care

  • Physical Medicine & Rehabilitation Physician
  • Rockwall, TX
  • NPI 1811366982
  Medicare reassignment
• Wfo Group LLC

  • Surgical Physician Assistant
  • Rowlett, TX
  • NPI 1639592009
  Medicare reassignment
• Spine Team Texas, PA

  • Physical Medicine & Rehabilitation Physician
  • Allen, TX
  • NPI 1053798983
  NPD
• Texas Health Back Care

  • Physical Medicine & Rehabilitation Physician
  • Southlake, TX
  • NPI 1770952830

  Surgical

  NPD
• Cedar Neurological Surgeons, PC

  • Neurological Surgery Physician
  • Cedar Rapids, IA
  • NPI 1588714216
  NPD (past)
• Loren J Mouw MD PC

  • Neurological Surgery Physician
  • Cedar Rapids, IA
  • NPI 1982931283
  NPD (past)

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

• Southlake Specialty Hospital, LLC

  • General Acute Care Hospital
  • Southlake, TX
  • NPI 1629064928
  Care Compare affiliation

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1750385456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 502",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762620502",
            "telephone_number": "214-227-2457",
            "fax_number": "214-699-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 E SOUTHLAKE BLVD",
            "address_2": "SUITE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926422",
            "telephone_number": "817-442-9300",
            "fax_number": "817-796-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "STEFANIE",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA04819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaroub Saleh, LPC
• Jobin Samuel
• Jake Sanchez, FNP
• Cortney Sanders
• Keshia Ahsaki Sanders, FNP-BC
• Sandra Lee Armstrong D.D.S,
• Sansome Surgical Services, PLLC
• Carmen Santiago, APRN-CNP
• Leonel Santibanez, DPT
• Pragya Yashwant Rao Saratkar

• Surgical Physician Assistant in Southlake, TX
• Providers in Southlake, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.