DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C) – Psychiatric/Mental Health Nurse Practitioner, NPI 1154819977

DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C) is a healthcare provider. based in Temple hills, Maryland. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP, PMHNP-BC, FNP-C. They hold a License No. R183268 (MD). The NPI Number for DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C) is 1154819977

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C)
NPI
1154819977
Phone
(301) 630-3900
Address
4467 OLD BRANCH AVE STE 207
Enumeration Date
26 April 2018
Last Update Date
5 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2405083363
Graduation Year
2018 (8 years ago)
PAC ID
1153674734
Professional Enrollment ID
I20181029002026
Address ID
MD207747128UP1014XWAYX400

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:8State licenses:1Other namesUpdated within 12 months

6,815 NURSE PRACTITIONER in MD

Provider Addresses for DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C)

  • 4467 OLD BRANCH AVE STE 207

    TEMPLE HILLS, MD 20748

    Phone: (301) 630-3900

    Type: Location

  • 1014, Andean Goose Way, Oak Grove, Upper Marlboro, Prince George's County, Maryland, 20774, United States

    UPPER MARLBORO, MD 207747128

    Phone: (240) 508-3363

    Type: Mailing

  • 1401 MERCANTILE LN STE 500-J

    LARGO, MD 207744301

    Phone: (240) 260-3147

    Fax: (240) 885-8733

    Type: Mailing

  • 1014 ANDEAN GOOSE WAY

    UPPER MARLBORO, MD 207747128

    Phone: (240) 508-3363

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2020-03-25

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181029002026INurse PractitionerDCTBD
I20200325003185INurse PractitionerMDTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 20748)

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Reviews

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Frequently asked questions

Can I use this page to confirm DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C)'s NPI?
Yes. DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C) is listed with NPI 1154819977 in the public NPI dataset.
Can I rely on DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C) being an active provider?
As of the registry snapshot, DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C) is marked active.
What taxonomy line describes DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C)?
For research purposes, treat DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C) as Psychiatric/Mental Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where is DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C) based?
DR. JOHANESE SANDY (DNP, PMHNP-BC, FNP-C) is tied to Temple Hills, Maryland in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
5 practice locations appear in the available data.

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