Individual provider Active NPI

Samantha Lynn Sandersen, NP

  • Family Nurse Practitioner
  • Seguin, TX
National Provider Identifier
1780454702
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1149140 Issued in TX
Practice address
1255 Ashby St Ste a
Seguin, TX 78155-5100
Phone
(832) 590-8049
NPI assigned
Jan 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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 1149140 TX Primary

Addresses

Primary practice location

1255 Ashby St Ste a
Seguin, TX 78155-5100

Mailing address

5224 75TH St Ste D
Lubbock, TX 79424-2525
Phone (806) 712-1096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR2 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

Enrollment IDStateProvider typePAC IDDetails
I20240122002882 TX Practitioner - Nurse Practitioner 3274985668 Reassigns benefits to 2 organizations
I20260515001163 AR Practitioner - Nurse Practitioner 3274985668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians UnityGroup PAC ID 6406014919, 61 clinicians

Practice addresses (Care Compare)

1001 Towson Ave
Fort Smith, AR 72901-4921
Phone (479) 441-4000

1255 Ashby St
Suite a
Seguin, TX 78155-5100
Phone (830) 590-8049

Hospital & facility affiliations

  • Christus Santa Rosa Hospital-San Marcos Hospital, San Marcos, TX, CCN 450272

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Unity Family CurrentSince Jan 10, 2024 Accepting new patients

Locations

7301 Rogers Ave
Fl 4
Fort Smith, AR 72903
Phone (479) 314-4900

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

8611 N Mopac Expy
Ste 250
Austin, TX 78759
Phone (281) 888-9999

1533 5th St
Ste B
Corpus Christi, TX 78404
Phone (361) 266-2233

5224 75th St
Ste D
Lubbock, TX 79424
Phone (806) 791-0042

598 N Union Ave
Ste 335
New Braunfels, TX 78130
Phone (830) 606-9111

2833 Babcock Rd
Ste 110
San Antonio, TX 78229
Phone (210) 692-2000

7402 John Smith Dr
Ste 101
San Antonio, TX 78229
Phone (210) 817-4848

11212 State Highway 151
Ste 300
San Antonio, TX 78251
Phone (210) 703-8200

1305 Wonder World Dr
Ste 101
San Marcos, TX 78666
Phone (512) 353-6430

1255 Ashby St
Ste A
Seguin, TX 78155
Phone (830) 379-9391

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1780454702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5224 75TH ST STE D",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242525",
            "telephone_number": "806-712-1096",
            "fax_number": "806-771-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 ASHBY ST STE A",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555100",
            "telephone_number": "832-590-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSEN",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1149140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seguin, TX

Sources for this page

Verify at the official NPI Registry.