Individual provider Active NPI

Jeffrey S Sanders, MD

  • Urology Physician
  • Waco, TX
National Provider Identifier
1790898146
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
J4498 Issued in TX
Practice address
601 W State Highway 6
Suite 105
Waco, TX 76710-5575
Phone
(254) 741-6113
Fax
(254) 741-6629
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X J4498 TX Primary

Addresses

Primary practice location

601 W State Highway 6
Suite 105
Waco, TX 76710-5575

Mailing address

601 W State Highway 6
Suite 105
Waco, TX 76710-5575
Phone (254) 741-6113

Other identifiers 1

IdentifierTypeStateIssuer
117026803MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110526000544 TX Practitioner - Urology 3274683875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Texas Southwestern Medical School at Dallas, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians

Practice addresses (Care Compare)

301 Richland W Cir
Providence Internal Medicine Clinic
Waco, TX 76712-7932
Phone (254) 537-6200

340 Richland W Cir
Ascension Medical Group Providence
Waco, TX 76712-7919
Phone (254) 537-6050

342 Richland W Cir
Waco, TX 76712-7919
Phone (254) 537-6600

601 W Hwy 6
Suite 106
Waco, TX 76710-5592
Phone (254) 776-7744

601 W Hwy 6 109
Fish Pond Surgery Center
Waco, TX 76710-5592
Phone (254) 751-9836

601 W State Hwy 6 101
Waco Center for Womens Health
Waco, TX 76710-5592
Phone (254) 772-5454

601 W State Hwy 6 105
Ascension Medical Group Providence Urology
Waco, TX 76710-5592
Phone (254) 741-6113

6901 Medical Pkwy
Waco, TX 76712-7910
Phone (254) 751-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health Alliance CurrentSince Sep 1, 2019 Accepting new patients
Providence Health Alliance CurrentSince Sep 1, 2019 Accepting new patients

Locations

601 W State Highway 6
Ste 105
Waco, TX 76710
Phone (254) 741-6113

301 Richland West Cir
Waco, TX 76712
Phone (254) 537-6200

Interoperability endpoints

  • Direct secure messaging: jeffrey.sanders.1@9635.direct.athenahealth.com

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 5

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1790898146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W STATE HIGHWAY 6",
            "address_2": "SUITE 105",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105575",
            "telephone_number": "254-741-6113",
            "fax_number": "254-741-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W STATE HIGHWAY 6",
            "address_2": "SUITE 105",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105575",
            "telephone_number": "254-741-6113",
            "fax_number": "254-741-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "J4498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117026803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.