Individual provider Active NPI

Sandra Stewart, NP

  • Nurse Practitioner
  • Apple Valley, CA
National Provider Identifier
1871651307
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP6891 Issued in CA
Practice address
19015 Town Center Dr Ste 206
Apple Valley, CA 92308-8996
Phone
(760) 240-4729
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP6891 CA Primary

Addresses

Primary practice location

19015 Town Center Dr Ste 206
Apple Valley, CA 92308-8996

Mailing address

19015 Town Center Dr Ste 206
Apple Valley, CA 92308-8996
Phone (760) 508-6727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050518000718 CA Practitioner - Nurse Practitioner 4880635002 Reassigns benefits to 1 organization
Practice locations: Apple Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19015 Town Ctr Dr
Suite 206
Apple Valley, CA 92308-8996
Phone (760) 240-4729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6891CAMDSpeech-Language Pathologist
NP6891CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness and Bladder Health Center Current Accepting new patients
Desert Valley Medical Group, Inc. Current Accepting new patients
Desert Valley Medical Group, Inc. CurrentSince Aug 31, 2009 Accepting new patients

Locations

19015 Town Center Dr
Ste 206
Apple Valley, CA 92308
Phone (619) 339-1866

17450 Main St
Hesperia, CA 92345
Phone (760) 244-8000

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

12276 Hesperia Rd
Ste 2
Victorville, CA 92395

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sandra.stewart.p1@direct.dvmg.nextgenshare.com

Organizations & group practices 3

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1871651307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19015 TOWN CENTER DR STE 206",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923088996",
            "telephone_number": "760-508-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19015 TOWN CENTER DR STE 206",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923088996",
            "telephone_number": "760-240-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SANDRA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP6891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.