Victorino Ano Sandoval Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD419068 Issued in PA

Practice address

6900 Hamilton Blvd
Trexlertown, PA 18087-9100

Phone

(610) 402-0101

Fax

(610) 402-0102

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• St. Pio Medical Services Corporation

  • Family Medicine Physician
  • Edinboro, PA
  • NPI 1144276692
  NPD (past) Authorized official
• Erie Healthcare Services Inc

  • Family Medicine Physician
  • Erie, PA
  • NPI 1578530317
  NPD (past)
• Northwest Physicians Associates PC

  • Family Medicine Physician
  • Meadville, PA
  • NPI 1144224973
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1891753158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 HAMILTON BLVD",
            "city": "TREXLERTOWN",
            "state": "PA",
            "postal_code": "180879100",
            "telephone_number": "610-402-0101",
            "fax_number": "610-402-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "VICTORINO",
        "middle_name": "ANO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD419068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Passamonte, PHARM D.
• John Peters, DO
• Thomas Austin Peterson, MD
• John Francis Prater
• Elaf Omar Saeed, DMD
• Sovereign Family Practice Inc
• Sovereign Urgent Care Inc
• Michael John Stecz, PT, DPT
• Melissa Anne Taylor, DO
• The Giant Company, LLC

• Family Medicine Physician in Trexlertown, PA
• Providers in Trexlertown, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.

Verify at the official NPI Registry.