Sandra Custodio, AG-PCNP - Medicare Nurse Practitioner in Charlottesville, VA

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Sandra Custodio, AG-PCNP is a medicare enrolled "Nurse Practitioner - Acute Care" physician in Charlottesville, Virginia. She graduated from medical school in 2000 and has 25 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice University Of Virginia Physicians Group and her current practice location is 415 Ray C Hunt Dr Ste 2200, Charlottesville, Virginia. You can reach out to her office (for appointments etc.) via phone at (434) 924-5700.

Sandra Custodio is licensed to practice in Virginia (license number 0024189672) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1669886396.

Contact Information

Sandra Custodio, AG-PCNP
415 Ray C Hunt Dr Ste 2200,
Charlottesville, VA 22903-2980
(434) 924-5700
Not Available

Map and Direction




Physician's Profile

Full NameSandra Custodio
GenderFemale
SpecialityNurse Practitioner
Experience25 Years
Location415 Ray C Hunt Dr Ste 2200, Charlottesville, Virginia
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Sandra Custodio graduated from medical school in 2000
  NPI Data:
  • NPI Number: 1669886396
  • Provider Enumeration Date: 06/20/2014
  • Last Update Date: 01/24/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 0244642825
  • Enrollment ID: I20240423001951

Medical Identifiers

Medical identifiers for Sandra Custodio such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1669886396NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RI0200XInternal Medicine - Infectious Disease 0024189672 (Virginia)Secondary
363LA2200XNurse Practitioner - Adult Health RN2328892 (Massachusetts)Secondary
363LA2100XNurse Practitioner - Acute Care 0024189672 (Virginia)Primary
163W00000XRegistered Nurse RN2328892 (Massachusetts)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
University Of Virginia Medical CenterCharlottesville, VAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
University Of Virginia Physicians Group48805907281547

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. Sandra Custodio allows following entities to bill medicare on her behalf.
Entity NameUniversity Of Virginia Physicians Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033138250
PECOS PAC ID: 4880590728
Enrollment ID: O20040102000780

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. Sandra Custodio 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
Sandra Custodio, AG-PCNP
Po Box 749112,
Atlanta, GA 30374-9112

Ph: (434) 295-1000		Sandra Custodio, AG-PCNP
415 Ray C Hunt Dr Ste 2200,
Charlottesville, VA 22903-2980

Ph: (434) 924-5700

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.