Tony O Sandstrom, CRNA | |
309 N Bartlett St, Shawano, WI 54166-2127 | |
(715) 526-2111 | |
(715) 526-9166 |
Full Name | Tony O Sandstrom |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 19 Years |
Location | 309 N Bartlett St, Shawano, Wisconsin |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780670034 | NPI | - | NPPES |
K400174628 | Other | WI | MEDICARE PTAN |
K400170079 | Other | WI | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | RN126117 (Tennessee) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 5845 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Firsthealth Moore Regional Hospital | Pinehurst, NC | Hospital |
Duke University Hospital | Durham, NC | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Duke University Health System Inc | 2567372345 | 852 |
Firsthealth Of The Carolinas Inc | 8820909377 | 114 |
Entity Name | Duke University Health System Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558392977 PECOS PAC ID: 2567372345 Enrollment ID: O20031201000521 |
Entity Name | American Anesthesiology Of North Carolina Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053677195 PECOS PAC ID: 2961316450 Enrollment ID: O20031229000004 |
Entity Name | Granville Health System |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275638512 PECOS PAC ID: 1052223757 Enrollment ID: O20040301000909 |
Entity Name | Firsthealth Of The Carolinas Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053482596 PECOS PAC ID: 8820909377 Enrollment ID: O20040308000442 |
Mailing Address | Practice Location Address |
---|---|
Tony O Sandstrom, CRNA 4401 Masthead St Ne, Suite 120, Albuquerque, NM 87109-4497 Ph: (505) 243-7729 | Tony O Sandstrom, CRNA 309 N Bartlett St, Shawano, WI 54166-2127 Ph: (715) 526-2111 |