Individual provider Active NPI

Miguel Jose Sagardia, MD

  • Internal Medicine Physician
  • Greensboro, NC
National Provider Identifier
1053390641
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2017-02301 Issued in NC
Practice address
102 Pomona Dr
Greensboro, NC 27407
Phone
(336) 299-0000
NPI assigned
Jan 11, 2006
Last updated
Jun 4, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME55187 FL
Internal Medicine Physician 207R00000X 2017-02301 NC Primary

Addresses

Primary practice location

102 Pomona Dr
Greensboro, NC 27407

Mailing address

907 Troublesome Creek Dr
Greensboro, NC 27455-8321
Phone (954) 609-2803

Other identifiers 2

IdentifierTypeStateIssuer
036419300MedicaidFL
09245OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180212000157 NC Practitioner - Emergency Medicine 4688696677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University Central del Caribe Escuela de Medicina, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moses Cone Medical Services IncGroup PAC ID 2769395458, 214 clinicians

Practice addresses (Care Compare)

709 Green Valley Rd
FL 2
Greensboro, NC 27408-7019
Phone (336) 890-2480

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2017-02301NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Physician Services, Inc. Internal Medicine Current Accepting new patients
Moses Cone Physician Services Inc CurrentSince Dec 11, 2017 Accepting new patients
Moses Cone Medical Services, Inc. Internal Medicine CurrentSince Mar 25, 2022 Accepting new patients
Moses Cone Physician Services, Inc CurrentSince Dec 11, 2017 Accepting new patients
Moses Cone Medical Services, Inc. CurrentSince Mar 25, 2022 Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine Past Accepting new patients
FL-I Medical Services, LLC Past Accepting new patients

Locations

102 Pomona Dr
Greensboro, NC 27407
Phone (336) 299-0000

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

300 E Wendover Ave
Fl 4
Greensboro, NC 27401
Phone (336) 663-5038

709 Green Valley Rd
Fl 2
Greensboro, NC 27408
Phone (336) 547-1792

940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848

Organizations & group practices 7

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1053390641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 TROUBLESOME CREEK DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274558321",
            "telephone_number": "954-609-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 POMONA DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27407",
            "telephone_number": "336-299-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGARDIA",
        "first_name": "MIGUEL",
        "middle_name": "JOSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME55187",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2017-02301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036419300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09245",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.