Sandra Kasumovic, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA1136 Issued in ID

Practice address

2716 Syringa LN
Caldwell, ID 83605-3052

Phone

(208) 477-1223

NPI assigned

Mar 3, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Sana Kasumovic Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID, NJ2 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 2

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gold Standard Medical Group PCGroup PAC ID 2961762554, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Gold Standard Medical Group PC

  • Internal Medicine Physician
  • Clifton, NJ
  • NPI 1043722853
  Medicare reassignment Care Compare group
• Sana Kasumovic PLLC

  • Physician Assistant
  • Caldwell, ID
  • NPI 1295680809
  NPD Authorized official
• DRX Paramus, LLC

  • Urgent Care Clinic/Center
  • Paramus, NJ
  • NPI 1316272685
  Medicare reassignment
• Ihpnj ER LLC

  • Emergency Medicine Physician
  • Hoboken, NJ
  • NPI 1225750946
  Medicare reassignment
• Perma Mental Health PLLC

  • Psychiatry Physician
  • Boise, ID
  • NPI 1104214618
  NPD (past)
• Revive Medical Group PC

  • Orthopaedic Surgery Physician
  • Clifton, NJ
  • NPI 1275457038
  NPD (past)

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1780009506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MAKIN LN",
            "city": "SUCCASUNNA",
            "state": "NJ",
            "postal_code": "078761111",
            "telephone_number": "208-850-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 SYRINGA LN",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836053052",
            "telephone_number": "208-477-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASUMOVIC",
        "first_name": "SANDRA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-03",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA1136",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA1136",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@healinghumanity.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2716 Syringa Ln",
            "city": "Caldwell",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836053052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SANA",
            "last_name": "KASUMOVIC",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cheryl L Jorgenson, R.D., L.D
• Anayeli Juarez
• Dominique Davi Juarez, LCSW-39611
• Carol Diane Julius, RD LD
• Eugene Kaplan, M.D.
• Jacqueline K Kavila, PHARMD
• Ke Therapy PLLC
• Christopher Ryan Keller, MD
• Melody Keller, ND
• Merle L. Keller III, MD

• Medical Physician Assistant in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.