John Andrew Sandoval, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00581 Issued in TX

Practice address

815 Highway 71 W
Suite 1150 BLDG 1
Bastrop, TX 78602-3590

Phone

(512) 321-1098

Fax

(512) 303-0885

NPI assigned

Apr 9, 2007

Last updated

Apr 27, 2016By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Aages Health Care Inc

  • Home Health Agency
  • Bastrop, TX
  • NPI 1609964279
  NPD (past) Authorized official

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1952424368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 HIGHWAY 71 W",
            "address_2": "SUITE 1150 BLDG 1",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023590",
            "telephone_number": "512-321-1098",
            "fax_number": "512-303-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HIGHWAY 71 W",
            "address_2": "SUITE 1150 BLDG 1",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023590",
            "telephone_number": "512-321-1098",
            "fax_number": "512-303-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE TX LIC NUM",
            "identifier": "PA00581",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERT NUM",
            "identifier": "1024681",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luther Wayne Ross, DOCTOR DENTAL SURGER
• Joslin Deyibeth Ruiz, FNP-C
• Sai Medical Group,P.a
• Sakura Behavioral Services Inc
• Sammy Lerma III MD PA
• Lindsey Sansing, MSN, APRN, PMHNP-BC
• Mischca Tapscott Scales, PH.D
• Kirsten Schacht
• Katherine Marie Schade, FNP-C
• Ulrike Schmidt, CPM; LM

• Physician Assistant in Bastrop, TX
• Providers in Bastrop, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.