Individual provider Active NPI

Michael R Sands, PA

  • Physician Assistant
  • Bethpage, NY
National Provider Identifier
1932339348
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012321 Issued in NY
Practice address
4230 Hempstead Tpke Ste 200
Bethpage, NY 11714-5700
Phone
(516) 731-1900
Fax
(516) 731-7302
NPI assigned
Jul 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 012321 NY Primary

Addresses

Primary practice location

4230 Hempstead Tpke Ste 200
Bethpage, NY 11714-5700

Mailing address

1010 Northern Blvd Ste 328
Great Neck, NY 11021-5329
Phone (516) 233-2484

Other practice location 1

11 Carleton Ave
East Islip, NY 11730-2108
Phone (631) 224-7474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140415000119 NY Practitioner - Physician Assistant 3971735598 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012321NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jennifer McMonigle Medical, P.C. CurrentSince Mar 1, 2026 Accepting new patients

Locations

554 Larkfield Rd
Ste 10G
East Northport, NY 11731
Phone (631) 230-6644

300 Garden City Plz
Ste 330
Garden City, NY 11530
Phone (516) 268-3026

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": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1932339348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 NORTHERN BLVD STE 328",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215329",
            "telephone_number": "516-233-2484",
            "fax_number": "516-304-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HEMPSTEAD TPKE STE 200",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145700",
            "telephone_number": "516-731-1900",
            "fax_number": "516-731-7302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Carleton Ave",
            "address_purpose": "LOCATION",
            "city": "East Islip",
            "state": "NY",
            "postal_code": "117302108",
            "country_code": "US",
            "telephone_number": "631-224-7474",
            "fax_number": "833-454-2143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDS",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-20",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

Verify at the official NPI Registry.