Active NPI
Noah Sandusky
- Physician Assistant
- McCamey, TX
National Provider Identifier
1790534477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17985
- Practice address
- 2500 Hwy 305
McCamey, TX 79752 - Phone
- (432) 652-8626
- NPI assigned
- May 15, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17985 | TX | Primary |
Addresses
Primary practice location
2500 Hwy 305
McCamey, TX 79752
Mailing address
3500 Camp Bowie Blvd
Fort Worth, TX 76107-2644
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2500 Hwy 305 S
McCamey, TX 79752
Phone (915) 652-8626
800 Medical Ctr Dr
Suite C
Decatur, TX 76234-3844
Phone (940) 626-2110
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McCamey County Hospital District | Current | Accepting new patients | |
| Christine Holland MD PA | Current | Accepting new patients |
Locations
800 Medical Center Dr
Ste D
Decatur, TX 76234
Phone (574) 339-0361
800 Medical Center Dr
Ste C
Decatur, TX 76234
Phone (940) 626-2110
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Decatur, TX
- NPI 1962677740
-
- Family Medicine Physician
- McCamey, TX
- NPI 1689899072
-
- Rural Health Clinic/Center
- McCamey, TX
- NPI 1255370474
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1790534477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 CAMP BOWIE BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761072644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 HWY 305",
"city": "MCCAMEY",
"state": "TX",
"postal_code": "79752",
"telephone_number": "432-652-8626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDUSKY",
"first_name": "NOAH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-15",
"last_updated": "2024-06-21",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA17985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McCamey, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.