Frederick Mark Sacks, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3768 Issued in OH

Practice address

1485 Commerce Park Drive
Tipp City, OH 45371

Phone

(937) 667-5126

Fax

(937) 667-7583

NPI assigned

Aug 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Fred M Sacks Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Fred M. Sacks, PH.D. & Associates

  • Clinical Psychologist
  • Tipp City, OH
  • NPI 1295088078
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1205844263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 COMMERCE PARK DRIVE",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "45371",
            "telephone_number": "937-667-5126",
            "fax_number": "937-667-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 COMMERCE PARK DRIVE",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "45371",
            "telephone_number": "937-667-5126",
            "fax_number": "937-667-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKS",
        "first_name": "FREDERICK",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0654635",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FRED",
            "last_name": "SACKS",
            "middle_name": "M",
            "prefix": "MR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Destiny Robison
• Daniel Steven Roth
• Carol A Ruschau
• Kelly Ryerson
• S&S Home Health Care LLC
• Hady Saleh, D.M.D.
• Scott R Scharnhorst, DDS
• Valerie Schenk-Greil, LPCC, NCC
• Erin Haley Schnippel, ATC
• Schulte Wellness, LLC

• Clinical Psychologist in Tipp City, OH
• Providers in Tipp City, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.