Organization Active NPI

Dan V Sandru MD LLC

  • Adult Health Nurse Practitioner
  • Jackson, NJ
National Provider Identifier
1962921841
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00741600 Issued in NJ
Legal business name
DAN V SANDRU MD LLC
Practice address
389 N County Line Rd
Jackson, NJ 08527-4426
Phone
(908) 330-7463
NPI assigned
Sep 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Authorized official

Name
Dr. Dan Victor Sandru, MDNPI 1548442031
Title
Physician
Phone
(908) 330-7463

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X 26NJ00741600 NJ Primary

Addresses

Primary practice location

389 N County Line Rd
Jackson, NJ 08527-4426

Mailing address

511 Hartshorne CT
Freehold, NJ 07728-8214
Phone (908) 330-7463

Other identifiers 1

IdentifierTypeStateIssuer
25MA08439200OtherNJMEDICAL LICENSE

Other names 1

  • Doctor's Office Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171121002821 NJ Part B Supplier - Clinic/Group Practice 0345507653 Receives reassigned benefits from 2 practitioners
Practice locations: Jackson, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2137518Dan V Sandru MD LLC389 North County Line Road, Jackson, NJ 08527Certificate of waiverSep 27, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16792/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505174400000",
    "number": "1962921841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 HARTSHORNE CT",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077288214",
            "telephone_number": "908-330-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 N COUNTY LINE RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274426",
            "telephone_number": "908-330-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAN V SANDRU MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-12",
        "last_updated": "2017-09-12",
        "status": "A",
        "authorized_official_last_name": "SANDRU",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "908-330-7463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00741600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "25MA08439200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctor's Office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.