Sandra K Antoniak, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

266006 Issued in NY

Practice address

3500 N Sabino Canyon Rd Unit 54
Tucson, AZ 85750-6141

Phone

(402) 305-1921

NPI assigned

Jun 28, 2007

Last updated

Dec 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, AZ2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Aleph Center, P.L.L.C.

  • Psychiatry Physician
  • Tucson, AZ
  • NPI 1215022157
  Medicare reassignment NPD
• Access: Supports for Living Inc

  • Multi-Specialty Clinic/Center
  • Middletown, NY
  • NPI 1528174976
  Medicare reassignment NPD
• Champlain Valley Physicians Hospital Medical Center

  • Internal Medicine Physician
  • Plattsburgh, NY
  • NPI 1124189782

  Family Medicine

  Medicare reassignment NPD
• Access: Supports for Living Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Middletown, NY
  • NPI 1790326320
  NPD

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1891992285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N SABINO CANYON RD UNIT 54",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857506141",
            "telephone_number": "402-305-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 N SABINO CANYON RD UNIT 54",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857506141",
            "telephone_number": "402-305-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIAK",
        "first_name": "SANDRA",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "266006",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "266006",
            "primary": true
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NY",
            "license": "266006",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luis Arturo Antillon Jr., O.D.
• Jessi Lin Antle-Williams, LPC-23028
• Kyle Antle, PT, DPT
• Rein Anton, MD
• Jessica Antonel
• Jodi Fay Antrobus, LPN
• Nneka Feora Anuligo, M.D.
• Brittany Anundson, PA-C
• Elhaam Anvar
• Farah Anwar, MD

• Psychiatry Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.