Sandra Custodio, AG-PCNP is a medicare enrolled "Nurse Practitioner - Acute Care" physician in Charlottesville, Virginia. Her current practice location is
415 Ray C Hunt Dr Ste 2200, Charlottesville, Virginia. You can reach out to her office (for appointments etc.) via phone at
(434) 924-5700.
Sandra Custodio is licensed to practice in Virginia (license number 0024189672) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1669886396.
Physician's Profile
Full Name | Sandra Custodio |
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Gender | Female |
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Speciality | |
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Experience | Years |
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Location | 415 Ray C Hunt Dr Ste 2200, Charlottesville, Virginia |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Sandra Custodio attended and graduated from in
NPI Data:
- NPI Number: 1669886396
- Provider Enumeration Date: 06/20/2014
- Last Update Date: 01/24/2025
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Sandra Custodio such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1669886396 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207RI0200X | Internal Medicine - Infectious Disease | 0024189672 (Virginia) | Secondary |
363LA2200X | Nurse Practitioner - Adult Health | RN2328892 (Massachusetts) | Secondary |
363LA2100X | Nurse Practitioner - Acute Care | 0024189672 (Virginia) | Primary |
163W00000X | Registered Nurse | RN2328892 (Massachusetts) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sandra Custodio is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Sandra Custodio, AG-PCNP Po Box 749112, Atlanta, GA 30374-9112 Ph: (434) 295-1000 | Sandra Custodio, AG-PCNP 415 Ray C Hunt Dr Ste 2200, Charlottesville, VA 22903-2980 Ph: (434) 924-5700 |
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