Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sandra Custodio, AG-PCNP

Individual provider Infectious Disease Physician · NPI 1669886396

Sandra Custodio, AG-PCNP is a Nurse Practitioner in Charlottesville, Virginia. Qualified in 2000, 26 years ago. Practices with University of Virginia Physicians Group, a 1,667-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Massachusetts and Virginia.

Years since qualifying
26
Licensed in
MA, VA
In the registry since
2014
Specialties on file
4

Practice location Address checks out

415 Ray C Hunt Dr Ste 2200
Charlottesville, VA 22903-2980
Phone: (434) 924-5700
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 — (434) 982-1700
  • 1215 Lee St, Charlottesville, VA 22908-6232 — (434) 982-1700

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 0024189672 (VA)
Infectious Disease Physician Taxonomy 207RI0200X · Licence 0024189672 (VA)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence RN2328892 (MA)
Registered Nurse Taxonomy 163W00000X · Licence RN2328892 (MA)

Record details

NPI number1669886396
Entity typeIndividual (Type 1)
GenderFemale
Credentials AG-PCNP
Sole proprietorNo
NPI enumeratedJune 20, 2014
Last updated in NPPESJanuary 24, 2025
Certification dateJanuary 24, 2025
Mailing addressPo Box 749112, Atlanta, GA 30374-9112

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice University Of Virginia Physicians Group — 1667 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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