Individual provider Active NPI

Maria Jose Sanandres, M.D.

  • Pediatrics Physician
  • Galveston, TX
National Provider Identifier
1992090211
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0040963 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-0526
Phone
(409) 772-2815
Fax
(979) 772-0744
NPI assigned
Jun 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0040963 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-0526

Mailing address

823 Winnie St
Galveston, TX 77550-5130
Phone (979) 220-5640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140923001820 TX Practitioner - Pediatric Medicine 0042439044 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0040963TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice Pediatrics CurrentSince Jul 8, 2014 Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

2785 Gulf Fwy S
Ste 200
League City, TX 77573
Phone (409) 772-3695

Interoperability endpoints

  • Direct secure messaging: msanandresmd19396@direct.utmb.edu

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": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1992090211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 WINNIE ST",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775505130",
            "telephone_number": "979-220-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550526",
            "telephone_number": "409-772-2815",
            "fax_number": "979-772-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANANDRES",
        "first_name": "MARIA",
        "middle_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "0040963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.