SANDY LAKE REHABILITATION AND CARE CENTER
NPI 1376969535
Skilled Nursing Facility in Coppell, TX

NPI Status: Active since March 12, 2014

Contact Information

1410 E SANDY LAKE RD
COPPELL, TX
ZIP 75019
Phone: (972) 304-4444

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  • Organization
  • Skilled Nursing Facility
  • Accepts Insurance
  • CLIA Number: 45D2002214
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 01-07-2026

About SANDY LAKE REHABILITATION AND CARE CENTER

This page provides the complete NPI Profile along with additional information for Sandy Lake Rehabilitation And Care Center, a provider established in Coppell, Texas operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1376969535 assigned on March 2014. The practitioner's primary taxonomy code is 314000000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Sandy Lake Rehabilitation And Care Center. The authorized official of this NPI record is Frederick Cerise Md (Ceo)

NPI
1376969535
Provider Legal Name
DALLAS COUNTY HOSPITAL DISTRICT
Other Organization Name
SANDY LAKE REHABILITATION AND CARE CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1410 E SANDY LAKE RD COPPELL, TX 75019
Location Phone
(972) 304-4444
Mailing Address
1410 E SANDY LAKE RD COPPELL, TX 75019
Mailing Phone
(972) 304-4444
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-12-2014
Last Update Date
03-11-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
License State
TX
Taxonomy Description
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
  • Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
  • Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Complete Silver (QualChoice) - POS
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold (QualChoice) - POS
  • Elite Gold (QualChoiceLife) - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Everyday Silver (QualChoiceLife) - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Standard Gold - PPO
  • Standard Gold + Vision + Adult Dental - PPO
  • Standard Silver - PPO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • MyBlue Health Bronze? 402 - HMO
  • Connect Bronze 5500 Indiv Med Deductible - HMO
  • Connect Bronze 6000 Indiv Med Deductible - HMO
  • Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - HMO
  • Connect Bronze 8500 Indiv Med Deductible - HMO
  • Connect Bronze CMS Standard - HMO
  • Connect Bronze DFW 6500 Indiv Med Deductible Enhanced Diabetes Care - HMO
  • Connect Gold 1000 Indiv Med Deductible - HMO
  • Connect Gold 2500 Indiv Med Deductible Enhanced Diabetes Care - HMO
  • Connect Gold 3250 Indiv Med Deductible - HMO
  • Connect Gold 3500 Indiv Med Deductible - HMO
  • Connect Gold CMS Standard - HMO
  • Connect Silver 3000 Indiv Med Deductible - HMO
  • Connect Silver 4000 Indiv Med Deductible - HMO
  • Connect Silver CMS Standard - HMO
  • Imperial Preferred Bronze - HMO
  • Imperial Preferred Gold - HMO
  • Imperial Preferred Gold Zero - HMO
  • Imperial Preferred Silver - HMO
  • Imperial Standard Bronze - HMO
  • Imperial Standard Gold - HMO
  • Imperial Standard Silver - HMO
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 12 - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with First 4 Primary Care Visits Free - HMO
  • Silver 8 - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

FREDERICK CERISE MD

Authorized Official Title
CEO
Authorized Official Phone
(214) 590-8006

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
001025870MEDICAID (05)TX 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D2002214
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
January 08, 2024
Certificate Expiration Date
January 07, 2026
Laboratory Director
JOHN WILSON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Sandy Lake Rehabilitation And Care Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for SANDY LAKE REHABILITATION AND CARE CENTER

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1376969535
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
231461861856
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 4 + 6 + 1 + 8 + 6 + 1 + 8 + 5 + 6 + 24 = 75
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 75 = 55

The NPI number 1376969535 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 8 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1033402466STAR HEALTH & REHAB, PA
Organization
Physical Medicine & Rehabilitation1410 E SANDY LAKE RD
COPPELL, TX 75019
(214) 808-7704
1568799914MASON COPPELL OP LLC
Organization
Skilled Nursing Facility1410 E SANDY LAKE RD
COPPELL, TX 75019
(972) 304-4444
1891118238COPPELL SNF OPERATIONS LLC
Organization
Skilled Nursing Facility1410 E SANDY LAKE RD
COPPELL, TX 75019
(972) 304-4444
1235582495MRS. MARY KATHRYN FRITH N.P.
Individual
Nurse Practitioner (Gerontology)1410 E SANDY LAKE RD
COPPELL, TX 75019
(972) 304-4444
1053369470VERICARE, P.C.
Organization
Psychologist (Clinical)1410 E SANDY LAKE RD
COPPELL, TX 75019
(800) 257-8715
1316413586 ROBERT ROY
Individual
Occupational Therapist1410 E SANDY LAKE RD
COPPELL, TX 75019
(972) 304-4444
1366270514 SARA STURDIVAN RD, LD
Individual
Dietitian, Registered1410 E SANDY LAKE RD
COPPELL, TX 75019
(214) 732-4132
1609175983STAR HEALTH & REHAB PA
Organization
Physical Medicine & Rehabilitation1410 E SANDY LAKE RD
COPPELL, TX 75019
(817) 284-9850

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1376969535, enumerated in the NPI registry as an "organization" on March 12, 2014

The provider is located at 1410 E Sandy Lake Rd Coppell, Tx 75019 and the phone number is (972) 304-4444

This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X

The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Arizona Complete. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 45D2002214 for a "skilled nursing facility/nursing facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on March 12, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.