CMS-1500 Box 24J / 33a • NPI
1003965450
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
364SC1501X (CMS 89)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Community Health — Public Health
Box 32 Service Location & ZIP+4
75 ROUTE 2, MASHANTUCKET PEQUOT INDIAN HEALTH SERVICES, LEDYARD, CT, 06339
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1003965450 (SANDRA BERARDY, AP RN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1003965450 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | SANDRA BERARDY, AP RN |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Community Health — Public Health NUCC Code: 364SC1501X (Clinical Nurse Specialist, Community Health/Public Health) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 75 ROUTE 2, MASHANTUCKET PEQUOT INDIAN HEALTH SERVICES, LEDYARD, CT, 06339 |
| Practice Telephone / Fax | Tel: (860) 312-8000 | Fax: (860) 312-8036 |
| Administrative Mailing Address | 24 BALDWIN CT, UNCASVILLE, CT, 06382-1833 |
| Enumeration & Last Sync | Enumerated: 2007-01-08 | CMS Record Updated: 2012-10-26 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (364SC1501X)
What Does Taxonomy Code 364SC1501X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 364SC1501X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Community Health — Public Health"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (SANDRA BERARDY, AP RN)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: CT | License: 001034 | Primary: Secondary |
364SC1501X — Clinical Nurse Specialist, Community Health/Public HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Community Health — Public Health | State: CT | License: 001034 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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