Individual provider Active NPI

Julie A Sanko, PA-C

  • Medical Physician Assistant
  • Holdrege, NE
National Provider Identifier
1851308100
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
713 Issued in NE
Practice address
1118 Burlington St
Holdrege, NE 68949-1705
Phone
(308) 995-3760
Fax
(308) 995-3775
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 713 NE Primary

Addresses

Primary practice location

1118 Burlington St
Holdrege, NE 68949-1705

Mailing address

1118 Burlington St
Holdrege, NE 68949-1705
Phone (308) 995-3760

Other identifiers 3

IdentifierTypeStateIssuer
713OtherNESTATE LICENSE
970030826OtherRAILROAD MEDICARE
283821AOtherRURAL HEALTH

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110822000488 NE Order and Referring Only - Physician Assistant 1658374269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
713NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Endocrine Consultants of Nebraska Past Accepting new patients

Organizations & group practices 1

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1851308100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 BURLINGTON ST",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689491705",
            "telephone_number": "308-995-3760",
            "fax_number": "308-995-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 BURLINGTON ST",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689491705",
            "telephone_number": "308-995-3760",
            "fax_number": "308-995-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANKO",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "713",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970030826",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL HEALTH",
            "identifier": "283821A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holdrege, NE

Sources for this page

Verify at the official NPI Registry.