Sandra Custodio, AG-PCNP in Charlottesville, VA

Sandra Custodio, AG-PCNP is a medicare enrolled "Nurse Practitioner - Acute Care" in Charlottesville, Virginia. She graduated from nursing school in 2000 and has 24 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice University Of Virginia Physicians Group, Greater New Bedford Community Health Center Inc and her current practice location is 1300 Jefferson Park Ave, Charlottesville, Virginia. You can reach out to her office (for appointments etc.) via phone at (434) 982-1700.

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.

Contact Information

	Sandra Custodio, AG-PCNP
	1300 Jefferson Park Ave, Charlottesville, VA 22903-3363
	(434) 982-1700
	(434) 244-4480

Map and Direction

Provider's Profile

Full Name	Sandra Custodio
Gender	Female
Speciality	Nurse Practitioner
Experience	24 Years
Location	1300 Jefferson Park Ave, Charlottesville, Virginia
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 graduated from nursing school in 2000

NPI Data:

NPI Number: 1669886396
Provider Enumeration Date: 06/20/2014
Last Update Date: 05/24/2024

Medicare PECOS Information:

PECOS PAC ID: 0244642825
Enrollment ID: I20240423001951

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
163W00000X	Registered Nurse	RN2328892 (Massachusetts)	Secondary
207RI0200X	Internal Medicine - Infectious Disease	0024189672 (Virginia)	Secondary
363LA2100X	Nurse Practitioner - Acute Care	0024189672 (Virginia)	Primary
363LA2200X	Nurse Practitioner - Adult Health	RN2328892 (Massachusetts)	Secondary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Southcoast Visiting Nurse Association Inc	Fairhaven, MA	Home health agency
Southcoast Hospitals Group	Fall river, MA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
University Of Virginia Physicians Group	4880590728	1415
Greater New Bedford Community Health Center Inc	7214848811	26

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sandra Custodio allows following entities to bill medicare on her behalf.

Entity Name	University Of Virginia Physicians Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033138250 PECOS PAC ID: 4880590728 Enrollment ID: O20040102000780

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 9007, Charlottesville, VA 22906-9007 Ph: () -	Sandra Custodio, AG-PCNP 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 Ph: (434) 982-1700

Reviews and Comments

Nurse Practitioner Nurses in Charlottesville, VA

Norma Branham, R.N., N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1215 Lee St, Charlottesville, VA 22908 Phone: 434-924-2047
Neil Peterson, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1215 Lee St, Charlottesville, VA 22908 Phone: 434-243-0075
Joy R Miller, PNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1215 Lee St, Charlottesville, VA 22908 Phone: 434-243-2617
Rebecca L Hand, ACNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1215 Lee St, Charlottesville, VA 22908 Phone: 434-982-1100
Megan E. Kingdon, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1215 Lee St, Charlottesville, VA 22908 Phone: 434-924-9400 Fax: 434-982-1618
Mrs. Stephanie Richardson Wilhelm, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 500 Martha Jefferson Dr, Charlottesville, VA 22911 Phone: 434-654-7150
Kimberly Conrad, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1240 Lee St, Charlottesville, VA 22908 Phone: 434-924-9333 Fax: 434-244-7526

Sandra Custodio, AG-PCNP - Medicare Nurse Practitioner in Charlottesville, VA