Active NPI
Joseph David Sacks, DPM
- Podiatrist
- Baltimore, MD
National Provider Identifier
1154339018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 1120
- Practice address
- 4717 Falls Road
Baltimore, MD 21209 - Phone
- (410) 366-0022
- Fax
- (410) 366-0322
- NPI assigned
- Aug 4, 2006
- Last updated
- Mar 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 1120 | MD | Primary |
Addresses
Primary practice location
4717 Falls Road
Baltimore, MD 21209
Mailing address
PO Box 16311
Baltimore, MD 21210
Phone (410) 366-0022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 347108000 | Medicaid | MD |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268006400000",
"number": "1154339018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16311",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21210",
"telephone_number": "410-366-0022",
"fax_number": "410-366-0322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4717 FALLS ROAD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21209",
"telephone_number": "410-366-0022",
"fax_number": "410-366-0322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACKS",
"first_name": "JOSEPH",
"middle_name": "DAVID",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2010-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MD",
"license": "1120",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "347108000",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.