Individual provider Active NPI

Roy John Sartori, D.O.

  • Internal Medicine Physician
  • Warren, OH
National Provider Identifier
1003876202
Registry record updated Dec 12, 2018
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Sep 19, 2024.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2622 Issued in OH
Practice address
667 Eastland Ave SE
Warren, OH 44484-4503
Phone
(330) 841-2378
Fax
(330) 841-4667
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS004082L PA
Internal Medicine Physician 207R00000X OS004082-L PA
Hospitalist Physician 208M00000X 34-002622 OH
Internal Medicine Physician 207R00000X 2622 OH Primary

Addresses

Primary practice location

667 Eastland Ave SE
Warren, OH 44484-4503

Mailing address

667 Eastland Ave SE
Warren, OH 44484-4503
Phone (330) 841-2378

Other identifiers 3

IdentifierTypeStateIssuer
100748346MedicaidPA
0007119980005MedicaidPA
0433374MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OS004082-LPAMDInternal Medicine Physician
34-002622OHMDHospitalist Physician
2622OHMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Medical Services, Inc. Internal Medicine Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1003876202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 EASTLAND AVE SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844503",
            "telephone_number": "330-841-2378",
            "fax_number": "330-841-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 EASTLAND AVE SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844503",
            "telephone_number": "330-841-2378",
            "fax_number": "330-841-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARTORI",
        "first_name": "ROY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS004082L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS004082-L",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "34-002622",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "2622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100748346",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007119980005",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0433374",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.