Individual provider Active NPI

Alexandra Carly Sacks, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1104081926
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
255750 Issued in NY
Practice address
230 Central Park W
New York, NY 10024-6029
Phone
(914) 629-3340
NPI assigned
Jul 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 255750 NY Primary

Addresses

Primary practice location

230 Central Park W
New York, NY 10024-6029

Mailing address

230 Central Park W
New York, NY 10024-6029
Phone (914) 629-3340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2014 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
255750NYMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1104081926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 CENTRAL PARK W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246029",
            "telephone_number": "914-629-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 CENTRAL PARK W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246029",
            "telephone_number": "914-629-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKS",
        "first_name": "ALEXANDRA",
        "middle_name": "CARLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "255750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.