Active NPI
Robert L Sasine, M.D.
- Emergency Medicine Physician
- Moultrie, GA
National Provider Identifier
1154401594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 025389
- Practice address
- 3131 S Main St
Moultrie, GA 31768-6925 - Phone
- (229) 985-3420
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 025389 | GA | Primary |
Addresses
Primary practice location
3131 S Main St
Moultrie, GA 31768-6925
Mailing address
3131 S Main St
Moultrie, GA 31768-6925
Phone (229) 985-3420
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000411683D | Medicaid | GA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025389 | GA | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154401594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3131 S MAIN ST",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317686925",
"telephone_number": "229-985-3420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3131 S MAIN ST",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317686925",
"telephone_number": "229-985-3420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SASINE",
"first_name": "ROBERT",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "025389",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000411683D",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Moultrie, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.