Audrey J Sanders
Individual provider Active NPI Physician Assistant · Longview, TX
NPI 1770079774 · NPPES record last updated Jul 7, 2026
Key facts
- NPI
- 1770079774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA20376 (TX)
- Practice address
- 707 E Marshall Ave
Longview, TX 75601-5545 - Phone
- (903) 315-4880
- Fax
- (903) 315-2833
- NPI assigned
- Jul 3, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.91 of 100
- Quality
- 76.55
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231108001744 | OK | Practitioner - Physician Assistant | 5890044614 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stillwater Medical Center Authority | Current |
Accepting new patients | |
| Stillwater Medical Center Authority | Physician Assistant | Current |
Accepting new patients |
| Midwest Indiana Four Medical Group, PLLC | Past | Accepting new patients |
Locations
417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770
518 E Lakeview Rd
Stillwater, OK 74075
Phone (405) 533-8990
Interoperability endpoints
- audrey.sanders.p1@direct.smc.nextgenshare.com
- awilson224132@ecommunitydirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 10002529A | IN | |
| Physician Assistant | 363A00000X | |||
| Medical Physician Assistant | 363AM0700X | 4789 | OK | |
| Physician Assistant | 363A00000X | PA20376 | TX | Yes |
Addresses
Primary practice location
707 E Marshall Ave
Longview, TX 75601-5545
Mailing address
1500 N Ritter Ave
Indianapolis, IN 46219-3027
Other practice location 1
700 E Marshall Ave
Longview, TX 75601-5580
Phone (903) 315-2000
Other practice location 2
650 W Carmel Dr Ste 110
Carmel, IN 46032-2502
Phone (317) 595-5698
Other practice location 3
518 E Lakeview Rd
Stillwater, OK 74075-2825
Phone (405) 533-8990
Other practice location 4
1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041
Other providers in Longview, TX
- Sanamente Aliados
- Juan Sanchez
- Liliana Sanchez
- Sanders Dental Associates PC
- Angelic Sanders
- David Lance Sanders
- Ellen Elaine Sanders
- Jamy Suzanne Sanders
- Jeremiah R Sanders
- Leslie Anna Sanders
All providers in Longview, TX · Physician Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.