350 LIBERTY ST
PAWCATUCK, CT 06379-1354 US PECOS Enrolled
Job L Sandoval
Internal Medicine Physician
- PAWCATUCK, CT
- Phone: (860)-599-9961
- Last Updated 8/23/2021
Overview
Job L Sandoval is a Internal Medicine Physician in the PAWCATUCK area and has over 40 years of experience. Job L Sandoval primary office location is at 350 LIBERTY ST and new patients are welcome to contact this healthcare provider for an appointment. We do not know where he was educated but we know that he graduated in 1984
Job L Sandoval is affiliated with ten hospitals in the PAWCATUCK area, including . The NPI number is 1790815157 and the information was updated approximately 3 years ago.
Job L Sandoval is affiliated with one medical group in the PAWCATUCK area, HARTFORD HEALTHCARE MEDICAL GROUP INC.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: NO
Participates in PECOS: YES (See any PECOS details below)
Contact Information
| License Number | State |
|---|---|
| 29158 | CT |
| 7098 | RI |
| Type/Issuer | Identifier | State |
|---|---|---|
| CONNECTICARE | 731424 | - |
| MEDICARE | D400654480 | CT |
| RI BLUE CHIP | 4095 | - |
| CONNECTICUT BLUE CROSS | 010007098RL01 | - |
| MEDICAID | 1790815157 | CT |
| BLUE SHIELD | 41605 | RI |
| MEDICARE | D400737416 | CT |
| MEDICAID | 9000416 | RI |
| CIGNA | 9258294 | - |
| AETNA | 0004674595 | - |
| RAILROAD MEDICARE | 110020788 | RI |
| CONNECTICUT MEDICAL ASSIS | 3066520 | - |
| RAILROAD MEDICARE | P02475705 | CT |
| OXFORD | P405784 | - |
| UNITED HEALTH | 0400364 | - |
| HEALTH NET | 0R0283 | - |
| FEDERAL BLUE SHIELD | 41605 | - |
| TRICARE | 050431424 02891 A001 | - |
| Taxonomy | State | Primary? |
|---|---|---|
| Internal Medicine Physician - Taxonomy Code 207R00000X | CT | Y |
| Internal Medicine Physician - Taxonomy Code 207R00000X | RI | N |
PECOS Details:
| Participates in PECOS: | YES |
| PECOS Individual Enrollment ID: | I20200519000478 |
| PECOS Individual PAC ID: | 3476538497 |
| Eligible to order/refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible to order/refer Durable Medical Equipment (DME) | Yes |
| Eligible to order/refer Home Health Agency (HHA) | Yes |
| Eligible to order/refer Power Mobility Devices (PMD) | Yes |
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