Individual provider Active NPI

Peggy A Sandberg, CRNA

  • Certified Registered Nurse Anesthetist
  • Fresno, CA
National Provider Identifier
1821042144
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA2215 Issued in CA
Practice address
Fresno & R Street
Fresno, CA 93721
Phone
(559) 459-6000
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN326621 CA
Certified Registered Nurse Anesthetist 367500000X NA2215 CA Primary

Addresses

Primary practice location

Fresno & R Street
Fresno, CA 93721

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Other identifiers 3

IdentifierTypeStateIssuer
NA0022150OtherCABLUE SHIELD OF CA
RN3266211MedicaidCA
RN3266210MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041118001201 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890759716 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1680 E Herndon Ave
Suite 101
Fresno, CA 93720-3384
Phone (559) 432-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2215CAMDMarriage & Family Therapist
NA2215CAMDCertified Registered Nurse Anesthetist
RN326621CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2003 Accepting new patients
Amsurg Fresno Ca Anesthesia LP CurrentSince Dec 19, 2023 Accepting new patients
Peggy Sandberg Professional Nursing Corporation Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2008 Accepting new patients
Sierra Anesthesai Associates Nurse Anesthetist, Certified Registered PastSince Nov 10, 2005 Accepting new patients

Locations

4500 Morning Dr
Ste 102
Bakersfield, CA 93306
Phone (661) 437-4140

445 S Cedar Ave
Fresno, CA 93702
Phone (559) 459-4000

1680 E Herndon Ave
Fresno, CA 93720
Phone (559) 432-4200

2823 Fresno St
Fl 2
Fresno, CA 93721

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

7055 N Fresno St
Ste 100
Fresno, CA 93720
Phone (559) 440-9100

1680 E Herndon Ave
Ste 101
Fresno, CA 93720
Phone (559) 432-4200

4300 Golden Center Dr
Ste E
Placerville, CA 95667
Phone (530) 344-1680

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1821042144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FRESNO & R STREET",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93721",
            "telephone_number": "559-459-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDBERG",
        "first_name": "PEGGY",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "RN326621",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA2215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "NA0022150",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN3266211",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN3266210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.