Individual provider Active NPI

Marshia K Sandy, PA-C

  • Physician Assistant
  • Fort Pierce, FL
National Provider Identifier
1972732261
Registry record updated Jul 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115233 Issued in FL
Practice address
2402 Frist Blvd Ste 201
Fort Pierce, FL 34950-4838
Phone
(772) 460-8838
Fax
(772) 460-8808
NPI assigned
Jul 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0003978 MD
Medical Physician Assistant 363AM0700X PA031233 DC
Physician Assistant 363A00000X PA9115233 FL Primary

Addresses

Primary practice location

2402 Frist Blvd Ste 201
Fort Pierce, FL 34950-4838

Mailing address

2402 Frist Blvd Ste 201
Fort Pierce, FL 34950-4838
Phone (772) 460-8838

Other practice location 1

1500 Forest Glenn RD
Silver Spring, MD 20910
Phone (301) 754-8621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211130001366 FL Practitioner - Physician Assistant 4486709508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Broward Neurosurgeons LLCGroup PAC ID 8123096690, 21 clinicians

Practice addresses (Care Compare)

1700 S 23Rd St
Fort Pierce, FL 34950-4803
Phone (772) 461-4000

2801 N St Rd
Suite 7
Margate, FL 33063-5727
Phone (954) 683-7041

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4426AZMDSpeech-Language Pathologist
PA031233DCMDMedical Physician Assistant
C0003978MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Mohave Sleep Medicine Associates LLC Past Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: msandy1142667@direct.trinity-health.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659139200000",
    "number": "1972732261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 FRIST BLVD STE 201",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504838",
            "telephone_number": "772-460-8838",
            "fax_number": "772-460-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 FRIST BLVD STE 201",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504838",
            "telephone_number": "772-460-8838",
            "fax_number": "772-460-8808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Forest Glenn RD",
            "address_purpose": "LOCATION",
            "city": "Silver Spring",
            "state": "MD",
            "postal_code": "20910",
            "country_code": "US",
            "telephone_number": "301-754-8621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDY",
        "first_name": "MARSHIA",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2022-07-30",
        "certification_date": "2022-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0003978",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA031233",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.