Individual provider Active NPI

Sandra C Peak, MD

  • Pediatrics Physician
  • Lewisville, TX
National Provider Identifier
1871675629
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K2094 Issued in TX
Practice address
1600 FM 544 Ste 100
Lewisville, TX 75056-4591
Phone
(972) 316-7400
Fax
(972) 316-0907
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K2094 TX Primary

Addresses

Primary practice location

1600 FM 544 Ste 100
Lewisville, TX 75056-4591

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address speak16120@CookChildrens.direct-ci.com
Direct Messaging Address speak16120@CookChildrens.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040823001424 TX Practitioner - Pediatric Medicine 6204800444 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Pediatrics CurrentSince Nov 22, 2010 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Nov 22, 2010 Accepting new patients
Cook Children'S Medical Center Past Accepting new patients

Locations

713 Hebron Pkwy
Ste 232
Lewisville, TX 75057
Phone (972) 316-7400

1600 FM 544
Ste 100
Lewisville, TX 75056
Phone (972) 316-7400

751 Hebron Pkwy
Ste 240
Lewisville, TX 75057
Phone (469) 549-4200

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: speak16120@cookchildrens.direct-ci.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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1871675629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 FM 544 STE 100",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750564591",
            "telephone_number": "972-316-7400",
            "fax_number": "972-316-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAK",
        "first_name": "SANDRA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K2094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "speak16120@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "713 Hebron Pkwy",
            "address_2": "STE 232",
            "city": "Lewisville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750575001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "speak16120@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1600 Fm 544 Ste 100",
            "city": "Lewisville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750564591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.