Individual provider Active NPI

Jason Evan Sagerman, M.D.

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1215907175
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD045278L Issued in PA
Practice address
10800 Knights Rd
Attn: Radiology
Philadelphia, PA 19114-4200
Phone
(215) 612-2610
Fax
(215) 612-5077
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD045278L PA Primary
Body Imaging Physician 2085B0100X MD045278L PA
Diagnostic Radiology Physician 2085R0202X 25MA06360600 NJ
Body Imaging Physician 2085B0100X 25MA06360600 NJ

Addresses

Primary practice location

10800 Knights Rd
Attn: Radiology
Philadelphia, PA 19114-4200

Mailing address

PO Box 782743
Attn: Credentialing
Philadelphia, PA 19178-2743
Phone (602) 910-6887

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

LicenseStateTypeSpecialty
25MA06360600NJMDDiagnostic Radiology Physician
MD045278LPAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Imaging of South Jersey PC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1215907175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 782743",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191782743",
            "telephone_number": "602-910-6887",
            "fax_number": "215-612-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "address_2": "ATTN: RADIOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-2610",
            "fax_number": "215-612-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGERMAN",
        "first_name": "JASON",
        "middle_name": "EVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD045278L",
            "primary": true
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "PA",
            "license": "MD045278L",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA06360600",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NJ",
            "license": "25MA06360600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.