DR. KELLY MICHAEL SANDALL (DO) – Emergency Medicine Physician, NPI 1194475228

DR. KELLY MICHAEL SANDALL (DO) is a healthcare provider. based in Corpus christi, Texas. specializing in EMERGENCY MEDICINE. They hold the professional credentials DO. They hold a License No. V1608 (TX). The NPI Number for DR. KELLY MICHAEL SANDALL (DO) is 1194475228

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
DR. KELLY MICHAEL SANDALL (DO)
NPI
1194475228
Phone
(361) 902-4100
Address
600 ELIZABETH ST
Enumeration Date
23 March 2022
Last Update Date
29 July 2024

Doctor Profile

Medical School Name
TOURO UN COL OF OSTEOPATHIC MEDICINE, HENDERSON
Secondary Phone
3613542000
Graduation Year
2022 (4 years ago)
PAC ID
5698157295
Group Practice PAC ID
6204280480
Professional Enrollment ID
I20240828000198
Address ID
TX781025312BE1500XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

4,051 EMERGENCY MEDICINE in TX

Provider Addresses for DR. KELLY MICHAEL SANDALL (DO)

  • 600 ELIZABETH ST

    CORPUS CHRISTI, TX 784042235

    Phone: (361) 902-4100

    Mailing address matches the actual address.

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: 2025-10-16

PECOS data refreshed: 2026-05-27

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
I20240828000198IEmergency MedicineTXTBD
I20251016004592IEmergency MedicineOHTBD

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 78404)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204280480View full group profile
NameSpecialtyState
Emergency MedicineMI
Emergency MedicineID
Nurse PractitionerTX
Emergency MedicineTX
Family Practice, Emergency MedicineTX
Nurse PractitionerFL
Emergency MedicineKY
Emergency MedicineTX
Emergency MedicineGA
Emergency MedicineAZ

Reviews

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Frequently asked questions

Is DR. KELLY MICHAEL SANDALL (DO) listed with a National Provider Identifier?
Yes — DR. KELLY MICHAEL SANDALL (DO) has NPI 1194475228 on file in the registry.
Is DR. KELLY MICHAEL SANDALL (DO) shown as active in public data?
Registry records indicate DR. KELLY MICHAEL SANDALL (DO) maintains an active NPI.
What area of care is associated with DR. KELLY MICHAEL SANDALL (DO)?
DR. KELLY MICHAEL SANDALL (DO)'s record emphasizes Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. KELLY MICHAEL SANDALL (DO) located near Corpus Christi?
DR. KELLY MICHAEL SANDALL (DO) currently maps to Corpus Christi, Texas in this extract.
When was this NPI issued?
Enumeration for DR. KELLY MICHAEL SANDALL (DO) is noted as March 23, 2022 where the registry provides it.

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