DR. JUSTIN E SANDHOLM O.D.
NPI 1023161791
Optometrist in Montgomery, AL

Q: What is Justin Sandholm's NPI number?

The NPI number for Justin Sandholm is 1023161791. It was assigned to this individual provider in the NPPES registry on January 18, 2007.

Q: What is Justin Sandholm's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Justin Sandholm was last updated on August 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 18, 2007PECOS Enrolled

42D MEDICAL GROUP, 300 SOUTH TWINING STREET, BLDG 760, MONTGOMERY, AL 36112(334) 953-5200 Get Directions Write a Review

NPPES record last updated: August 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 6, 2025, Nov 16, 2023, Jul 6, 2022 and 1 more (4 updates tracked since 2019).

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About Dr. Justin E Sandholm O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JUSTIN E SANDHOLM O.D. (NPI 1023161791) is an individual optometrist in Montgomery, Alabama, licensed in Colorado (2876) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023161791

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. JUSTIN E SANDHOLMCredential: O.D.

Location Address42D MEDICAL GROUP, 300 SOUTH TWINING STREET, BLDG 760Montgomery, AL 36112-6027

Mailing Address42d Medical Group, 300 South Twining Street, Bldg 760Montgomery, AL 36112-6027 · (334) 953-5200

Phone(334) 953-5200

Sole ProprietorNo

Enumeration DateJanuary 18, 2007

Last NPPES UpdateAugust 18, 20254 updates tracked since enumeration

NPPES CertifiedAugust 7, 2025

✔ NPI 1023161791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in CO · 2876

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

42D MEDICAL GROUP, Montgomery, AL 36112

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Justin E Sandholm O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36112 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$122.31 typical visit price

range $52.65 – $161.63

Typical copayment $30.57 (range $13.16 – $40.40)

Most-billed visit code 99204

Established Patient

$66.08 typical visit price

range $16.56 – $131.65

Typical copayment $16.52 (range $4.14 – $32.91)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROSS MICHAEL CANUP M.D.

Family Medicine

42D MEDICAL GROUP, 300 S. TWINING ST. BLDG 760
MAXWELL AFB, AL 36112

Montgomery County (334) 953-5200

KATLYN GORGUS

Military Health Care Provider (Independent Duty Medical Technicians)

42D MEDICAL GROUP, 300 S. TWINING ST., BLDG 760
MAXWELL AFB, AL 36112

Montgomery County (580) 481-7082

DR. JOLYN INEZ TATUM PHD

Psychologist (Health)

42D MEDICAL GROUP, 300 S. TWINING ST., BLDG 760
MAXWELL AFB, AL 36112

Montgomery County (334) 953-5200

MR. CHRISTOPHER W. KELLY FNP-C APRN, MSN, MSM

Nurse Practitioner (Family)

42D MEDICAL GROUP, 300 S. TWINING ST BLDG 760
MAXWELL AFB, AL 36112

Montgomery County (334) 953-5200

RANDI HUGHEY LICSW

Social Worker (Clinical)

42D MEDICAL GROUP, 300 S TWINING ST BLDG 760
MAXWELL AFB, AL 36112

Montgomery County (334) 953-3368

MRS. SARAH MILLER LICSW

Social Worker (Clinical)

42D MEDICAL GROUP, 300 S. TWINNING ST. BLDG 760
MAXWELL AFB, AL 36112

Montgomery County (334) 953-5200

JOHN CAMPBELL JR.

Psychologist

42D MEDICAL GROUP, 300 TWINING STREET
MAXWELL AFB, AL 36112

Montgomery County (334) 953-5143

DR. NIKKI LOUISE MOCHKO D.D.S.

Dentist

42D MEDICAL GROUP, 300 S TWINING ST BLDG 760
MAXWELL AFB, AL 36112

Montgomery County (334) 953-5200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Sandholm's NPI number?

The NPI number for Justin Sandholm is 1023161791. It was assigned to this individual provider in the NPPES registry on January 18, 2007.

Where is Justin Sandholm located?

Justin Sandholm practices at 42D Medical Group 300 South Twining Street, Bldg 760, Montgomery, AL 36112. The listed phone number is (334) 953-5200.

What is Justin Sandholm's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Justin Sandholm enrolled in Medicare?

Yes. Justin Sandholm is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Justin Sandholm was last updated on August 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.