Sandra Medakovich, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN2303850 Issued in MA

Practice address

366 Shrewsbury St
Worcester, MA 01604-4647

Phone

(508) 368-7890

Fax

(508) 796-8111

NPI assigned

Dec 28, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sandra.medakovich.npi1811403876.reliant@direct.optumcare.masshiway.net

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.

• Reliant Medical Group, Inc

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1720017528
  Medicare reassignment NPD
• Reliant Medical Group, Inc

  • Physical Therapist
  • Worcester, MA
  • NPI 1295827962
  NPD (past)
• Cloud Health Medical Group, P.a.

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1528744935
  NPD (past)

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1811403876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 SHREWSBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044647",
            "telephone_number": "508-368-7890",
            "fax_number": "508-796-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 SHREWSBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044647",
            "telephone_number": "508-368-7890",
            "fax_number": "508-796-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDAKOVICH",
        "first_name": "SANDRA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-28",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "APRN-3475",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.023232",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61055169",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "345737",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2303850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meadowbrook Care Center LLC
• Jennifer Lynn Meadows, BCBA
• Emily Meara, MD
• Rachael Measer, LICSW, MSW
• Rumali S. Medagoda, M.D.
• Peter Medawar
• Jennifer Medeiros, PT
• Paul Michael Medeiros, OTR/L
• Medi-Rents, Inc
• Medical Billing and Collections, LLC

• Nurse Practitioner in Worcester, MA
• Providers in Worcester, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.