Active NPI
Sandy L Stetz, P.A.-C., M.ED.
- Physician Assistant
- Trophy Club, TX
National Provider Identifier
1831199140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA05438
- Practice address
- 301 Trophy Lake Dr Unit 136
Trophy Club, TX 76262-5237 - Phone
- (817) 430-9111
- Fax
- (817) 430-8911
- NPI assigned
- Jul 28, 2005
- Last updated
- Jul 15, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA05438 | TX | Primary |
| Medical Physician Assistant | 363AM0700X | PA05438 | TX |
Addresses
Primary practice location
301 Trophy Lake Dr Unit 136
Trophy Club, TX 76262-5237
Mailing address
2628 Long Prairie Rd
Suite 107
Flower Mound, TX 75022-4839
Phone (972) 539-3695
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Education, Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delphi Healthcare Partners of Maryland LLC | Past | Accepting new patients | |
| Lumincare Physician Group, PA | Medical | Past | Accepting new patients |
| Jessica R. Judge DC, LLC | Past | Accepting new patients |
Interoperability endpoints
- sandy.stetz.1@27041.direct.athenahealth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436918400000",
"number": "1831199140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2628 LONG PRAIRIE RD",
"address_2": "SUITE 107",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "750224839",
"telephone_number": "972-539-3695",
"fax_number": "972-539-5419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 TROPHY LAKE DR UNIT 136",
"city": "TROPHY CLUB",
"state": "TX",
"postal_code": "762625237",
"telephone_number": "817-430-9111",
"fax_number": "817-430-8911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STETZ",
"first_name": "SANDY",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "P.A.-C., M.ED.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-28",
"last_updated": "2015-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA05438",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA05438",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trophy Club, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.