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SANDIE JEAN DERIVAL APRN
NPI 1508266842
Nurse Practitioner in New Haven, CT

Active since August 22, 2014PECOS Enrolled
20 YORK STREET, CB-2041, NEW HAVEN, CT 06510(203) 688-4748(203) 688-4740 Get Directions Write a Review

NPPES record last updated: June 27, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Sandie Jean Derival Aprn NPPES

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

SANDIE JEAN DERIVAL APRN (NPI 1508266842) is an individual nurse practitioner in New Haven, Connecticut, licensed in Connecticut (005821) and active in the NPI registry since August 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1508266842
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameSANDIE JEAN DERIVALCredential: APRN
Location Address20 YORK STREET, CB-2041New Haven, CT 06510
Mailing Address20 York Street, Cb-2041New Haven, CT 06510-3220 · (203) 688-4748 · Fax (203) 688-4740
Phone(203) 688-4748
Fax(203) 688-4740
Sole ProprietorNo
Enumeration DateAugust 22, 2014
Last NPPES UpdateJune 27, 2018
✔ NPI 1508266842 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CT · 005821
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 5821 (CT)
20 YORK STREET, CB-2041, New Haven, CT 06510
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Other Names 1

Former Name (1)Sandie Jean Aprn

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sandie Jean Derival Aprn 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Sandie Derival reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mill Hill Medical Consultants Inc
Same address
Hospitalist
20 YORK ST, CB 2041
New Haven, CT 06510
  • Reassigned Medicare billing, Connecticut enrollment
  • Medicare enrollment name: Northeast Medical Group Inc
  • 1,824 clinicians in this Medicare group
NPI 1952624769 (203) 688-4741
Yale University
0.4 mi
Advanced Practice Midwife
100 CHURCH ST S STE 200, YALE SCHOOL OF NURSING
New Haven, CT 06519
  • Reassigned Medicare billing, Connecticut enrollment
  • 3,728 clinicians in this Medicare group
NPI 1124148887 (203) 737-5432

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06510 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
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 20

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

ALINA RAKHUBA MD
Hospitalist
20 YORK STREET, CB-2041
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-4748
MARIBEL CABRERA MARTINEZ M.D.
Hospitalist
20 YORK STREET, CB-2041
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-4748
OMAR YASSER ABED SHAKHTOUR MBBS
Hospitalist
20 YORK STREET, CB-2041
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (036) 884-7482
SCOTT NAVARRETT M.D.
Hospitalist
20 YORK STREET, CB-2041
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-4748
DR. PHYLLIS TAWIAH MD
Hospitalist
20 YORK STREET, CB-2041
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-4748
MISS DANIELLE PAZIENZA PA-C
Physician Assistant (Medical)
20 YORK STREET, CB-2041
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-4748
DR. NIDHI SHAH M.D.
Hospitalist
20 YORK STREET, CB-2041
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-4748
DR. OSAMA KANDALAFT MD
Internal Medicine
20 YORK STREET, CB-2041
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-4748

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 Sandie Derival's NPI number?

The NPI number for Sandie Derival is 1508266842. It was assigned to this individual provider in the NPPES registry on August 22, 2014. The provider is also known as Sandie Jean Aprn.

Where is Sandie Derival located?

Sandie Derival practices at 20 York Street, Cb-2041, New Haven, CT 06510. The listed phone number is (203) 688-4748.

What is Sandie Derival's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Sandie Derival enrolled in Medicare?

Yes. Sandie Derival is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Sandie Derival's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sandie Derival reassigns Medicare benefits to 2 organizations: Mill Hill Medical Consultants Inc (New Haven, CT) and Yale University (New Haven, CT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sandie Derival's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sandie Derival was last updated on June 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.