Active NPI
Carl Andrew Sandstrom, MSPT
- Physical Therapist
- Warren, PA
National Provider Identifier
1952387045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT007634L
- Practice address
- 2265 Market St
Suite a
Warren, PA 16365-4625 - Phone
- (814) 726-9050
- Fax
- (814) 726-9629
- NPI assigned
- Dec 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | DAPT000113 | PA | |
| Physical Therapist | 225100000X | PT007634L | PA | Primary |
Addresses
Primary practice location
2265 Market St
Suite a
Warren, PA 16365-4625
Mailing address
2265 Market St Ste a
Warren, PA 16365-4682
Phone (814) 726-9050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1028776920001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2265 Market St a
Warren, PA 16365-4682
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DAPT000113 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinical Therapeutics Inc | Physical Therapist | Current | Accepting new patients |
Locations
300 State St
Ste 104
Erie, PA 16507
Phone (814) 454-5251
2265 Market St
Ste A
Warren, PA 16365
Phone (814) 726-9050
Interoperability endpoints
- andys@ctiphysicaltherapy.medentdirect.com
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": "1135036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718841600000",
"number": "1952387045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2265 MARKET ST STE A",
"city": "WARREN",
"state": "PA",
"postal_code": "163654682",
"telephone_number": "814-726-9050",
"fax_number": "814-726-9629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2265 MARKET ST",
"address_2": "SUITE A",
"city": "WARREN",
"state": "PA",
"postal_code": "163654625",
"telephone_number": "814-726-9050",
"fax_number": "814-726-9629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDSTROM",
"first_name": "CARL",
"middle_name": "ANDREW",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-20",
"last_updated": "2024-06-20",
"certification_date": "2024-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "DAPT000113",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT007634L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1028776920001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Warren, PA
- Tessa Elizabeth Sager, DPT
- Saint Vincent Medical Education and Research Institute (Saint Vincent Medical Group Obstetrics and Gynecology)
- Kari Ruth Salapek, LPC, ATR-BC
- Stevie Lynn Samuelson
- Ashley Sanders, PHARMD
- Gabrielle Saporito, BSN, RN
- Dacin I Schoenborn, PA
- Gerald J Schoenborn, DMD
- Scott Orrin Schoenborn, MD
- Valeriy Sedov, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.