Dr Sandra Ana Antonovic, MD - Medicare Pediatrics in Tigard, OR

Dr Sandra Ana Antonovic, MD is a medicare enrolled "Pediatrics" physician in Tigard, Oregon. Her current practice location is 12442 Sw Scholls Ferry Rd, Suite 205, Tigard, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 216-9140.

Dr Sandra Ana Antonovic is licensed to practice in Oregon (license number MD23792) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1184773319.

Contact Information

Dr Sandra Ana Antonovic, MD
12442 Sw Scholls Ferry Rd, Suite 205,
Tigard, OR 97223-0804
(503) 216-9140
(503) 216-9145



Physician's Profile

Full NameDr Sandra Ana Antonovic
GenderFemale
SpecialityPediatrics
Location12442 Sw Scholls Ferry Rd, Tigard, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1184773319
  • Provider Enumeration Date: 01/09/2007
  • Last Update Date: 10/13/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 9032335922
  • Enrollment ID: I20140730000710

Medical Identifiers

Medical identifiers for Dr Sandra Ana Antonovic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1184773319NPI-NPPES
272420MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics MD23792 (Oregon)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Sandra Ana Antonovic allows following entities to bill medicare on her behalf.
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023488343
PECOS PAC ID: 0648183608
Enrollment ID: O20031106000652

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Sandra Ana Antonovic is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Sandra Ana Antonovic, MD
Po Box 3158,
Portland, OR 97208-3158

Ph: () -
Dr Sandra Ana Antonovic, MD
12442 Sw Scholls Ferry Rd, Suite 205,
Tigard, OR 97223-0804

Ph: (503) 216-9140

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Pediatrics Doctors in Tigard, OR

Margaret Allison Baynham, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 7213 Sw Hazelfern Rd, Tigard, OR 97224
Phone: 503-214-2064    Fax: 503-598-3600
Leila Hotaki Mesch, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 12442 Sw Scholls Ferry Rd Ste 205, Tigard, OR 97223
Phone: 503-216-9140    
Kirsten Crowley, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 12442 Sw Scholls Ferry Rd, Suite 205, Tigard, OR 97223
Phone: 503-216-9140    Fax: 503-216-9145
Carol Lynn Schriner, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 9250 Sw Hall Blvd, Tigard, OR 97223
Phone: 503-293-0161    Fax: 503-221-4451
Dr. Zaid Saad Al-mulla, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 9735 Sw Shady Ln Ste 300, Tigard, OR 97223
Phone: 503-466-1779    Fax: 503-598-9030
Sarah A Leffler Wagoner, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 12442 Sw Scholls Ferry Rd Ste 205, Tigard, OR 97223
Phone: 503-216-9140    

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