MS. MARY MADRIGAL SANDOVAL RN, PHN, FNP - NPI 1760829543 - Nurse Practitioner in San Jacinto, CA

Q: What is Mary Sandoval's NPI number?

The NPI number for Mary Sandoval is 1760829543. It was assigned to this individual provider in the NPPES registry on June 3, 2013.

Q: What is Mary Sandoval's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Sandoval was last updated on August 29, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

On this page

About Ms. Mary Madrigal Sandoval Rn, Phn, Fnp NPPES

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

MS. MARY MADRIGAL SANDOVAL RN, PHN, FNP (NPI 1760829543) is an individual family provider in San Jacinto, California, licensed in California (95013490) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1760829543

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMS. MARY MADRIGAL SANDOVALCredential: RN, PHN, FNP

Location Address607 DONNA WAYSan Jacinto, CA 92583-5517

Mailing Address11980 Mount Vernon AveGrand Terrace, CA 92313-5172 · (909) 864-1097

Phone(951) 654-0803

Fax(951) 654-3917

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJune 3, 2013

Last NPPES UpdateAugust 29, 20202 updates tracked since enumeration

NPPES CertifiedAugust 29, 2020

✔ NPI 1760829543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95013490

Also ListedRegistered Nurse · Community HealthTaxonomy 163WC1500X · License 531242 (CA)

607 DONNA WAY, San Jacinto, CA 92583

Open in Google Maps ↗

Other Identifiers 3

Other95013490CA · Board Of Registered Nursing

Other59378CA · Board Of Registered Nursing

Other531242CA · Board Of Registered Nursing

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Mary Madrigal Sandoval Rn, Phn, Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638597750

PECOS Enrollment IDI20200922000286

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 92583 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

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

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 10

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

DR. BRUCE MICHAEL PETERSON DDS

Dentist (General Practice)