JESSICA MARIE SANFORD (CNP) – Adult Health Nurse Practitioner, NPI 1104398833
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,191 NURSE PRACTITIONER in IN
Provider Addresses for JESSICA MARIE SANFORD (CNP)
36 Valley Dr
Lawrenceburg, IN 470251084
Phone: (812) 537-0930
Type: Location
PNC Park Box Office, West General Robinson Street, North Shore, Pittsburgh, Allegheny County, Pennsylvania, 15212, United States
PITTSBURGH, PA 152519500
Phone: (512) 575-8028
Type: Mailing
3512, Stellhorn Road, Fort Wayne, Allen County, Indiana, 46815, United States
FORT WAYNE, IN 46815
Phone: (260) 483-9081
Fax: (260) 483-9196
Type: Location
6557 STONELAKE WAY
FAIRFIELD TOWNSHIP, OH 450118160
Phone: (513) 828-1578
Type: Mailing
11500 NORTHLAKE DR
CINCINNATI, OH 452491650
Phone: (513) 742-6310
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $184.
Total Amount is formed as General ($184) + Research ($0) + Ownership ($0) = $184.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Dermavant Sciences, Inc. ($184).
Total Amount
$184
General + Research + Ownership
Payments
23
Total payment records
General Amount
$184
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dermavant Sciences, Inc. | $184 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-05-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200521001918 | I | Nurse Practitioner | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99221 | Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes | 16 | 16 | $0 |
Insurance plans in this area (ZIP 47025)
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