HOLLY SANDBERG (PA-C) – Physician Assistant, NPI 1407626153

HOLLY SANDBERG (PA-C) is a healthcare provider. based in Northlake, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA17368 (TX). The NPI Number for HOLLY SANDBERG (PA-C) is 1407626153

Main info

Female
3 Years Of Experience
Name
HOLLY SANDBERG (PA-C)
NPI
1407626153
Phone
(814) 969-1597
Address
5001 STATE HIGHWAY 114 APT 2309
Enumeration Date
4 January 2024
Last Update Date
4 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4693127777
Graduation Year
2023 (3 years ago)
PAC ID
5698110708
Group Practice PAC ID
3072679828
Professional Enrollment ID
I20240228003928
Address ID
TX750193207CO330XXRDXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

8,497 PHYSICIAN ASSISTANT in TX

Provider Addresses for HOLLY SANDBERG (PA-C)

  • 5001 STATE HIGHWAY 114 APT 2309

    NORTHLAKE, TX 762622267

    Phone: (814) 969-1597

    Type: Mailing

  • 3901 W 15TH ST

    PLANO, TX 750757738

    Phone: (814) 969-1597

    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: 2024-02-28

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240228003928IPhysician AssistantTXTBD

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 76262)

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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: 3072679828View full group profile
NameSpecialtyState
Internal MedicineTX
Emergency MedicineTX
Nurse PractitionerTX
Emergency MedicineTX
Nurse PractitionerTX
Emergency MedicineLA
Family Practice, Emergency MedicineTX
Physician AssistantKS
Emergency Medicine, Undersea And Hyperbaric MedicineTX
Emergency MedicineTX

Reviews

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Frequently asked questions

What unique ID ties claims to HOLLY SANDBERG (PA-C)?
NPI 1407626153 is assigned to HOLLY SANDBERG (PA-C) under the national enumeration system.
Is HOLLY SANDBERG (PA-C) currently active in the NPI registry?
CMS-published data lists HOLLY SANDBERG (PA-C) as an active registrant.
Does HOLLY SANDBERG (PA-C) list a primary specialty?
If you are matching referrals, note Physician Assistant for HOLLY SANDBERG (PA-C). Clinical services aligned with this taxonomy classification.
Does HOLLY SANDBERG (PA-C) practice in Texas?
You will see Northlake, Texas on file for HOLLY SANDBERG (PA-C) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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