Individual provider Active NPI

George Douglas Sagrera Sr., MD

  • Family Medicine Physician
  • New Iberia, LA
National Provider Identifier
1093772402
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
008438 Issued in LA
Practice address
602 W Saint Peter St
New Iberia, LA 70560-3633
Phone
(337) 364-8196
Fax
(337) 367-5258
NPI assigned
Apr 28, 2006
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 008438 LA Primary
General Practice Physician 208D00000X 008438 LA

Addresses

Primary practice location

602 W Saint Peter St
New Iberia, LA 70560-3633

Mailing address

602 W Saint Peter St
New Iberia, LA 70560-3633
Phone (337) 364-8196

Other identifiers 1

IdentifierTypeStateIssuer
1062138MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20100817001519 LA Practitioner - Family Practice 6204960834 Practice locations: New Iberia, LA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1959
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

602 W St Peter St
New Iberia, LA 70560-3633
Phone (337) 364-8196

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions16
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008438LAMDFamily Medicine Physician

Hospital & facility affiliations 7

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1093772402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 W SAINT PETER ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705603633",
            "telephone_number": "337-364-8196",
            "fax_number": "337-367-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W SAINT PETER ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705603633",
            "telephone_number": "337-364-8196",
            "fax_number": "337-367-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGRERA",
        "first_name": "GEORGE",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "008438",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "008438",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1062138",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

Verify at the official NPI Registry.