Individual provider Active NPI

Sandra R Stine, MD

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1790768356
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME51069 Issued in FL
Practice address
5540 E Grant St Ste a
Orlando, FL 32822-1668
Phone
(407) 367-4715
Fax
(321) 203-4606
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME51069 FL Primary

Addresses

Primary practice location

5540 E Grant St Ste a
Orlando, FL 32822-1668

Mailing address

5540 E Grant St Ste a
Orlando, FL 32822-1668
Phone (407) 367-4715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040115000041 FL Practitioner - Internal Medicine 4385545201 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Physicians Network Inc Internal Medicine CurrentSince Apr 30, 2020 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Primary Care Specialists, LLC Past Accepting new patients
Orlando Health Medical Group Inc Internal Medicine Past Accepting new patients

Locations

5540 E Grant St
Ste A
Orlando, FL 32822
Phone (407) 281-7728

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

Interoperability endpoints

  • Direct secure messaging: sstine26038@orlandohealth.medalliesdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1790768356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5540 E GRANT ST STE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328221668",
            "telephone_number": "407-367-4715",
            "fax_number": "321-203-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 E GRANT ST STE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328221668",
            "telephone_number": "407-367-4715",
            "fax_number": "321-203-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINE",
        "first_name": "SANDRA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME51069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.