Sarah Dutta, OB-GYN, S.C.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036-113555 Issued in IL

Legal business name

SARAH DUTTA, OB-GYN, S.C.

Practice address

107 N Regency Dr
Suite 3
Bloomington, IL 61701-3505

Phone

(309) 661-0406

Fax

(309) 661-6446

NPI assigned

Jul 22, 2013

Organization subpart

No

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

Authorized official

Name

Sarah Dutta, MDNPI 1083648240

Title

Owner/President

Phone

(309) 661-0406

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarah Dutta, MD

  • Obstetrics & Gynecology Physician
  • Bloomington, IL
  • NPI 1083648240
  Medicare reassignment Care Compare group NPD Authorized official
• Betsy Lucille Aughenbaugh, MSN, FNP-BC

  • Family Nurse Practitioner
  • Bloomington, IL
  • NPI 1992583165

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1275975146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N REGENCY DR",
            "address_2": "SUITE 3",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013505",
            "telephone_number": "309-661-0406",
            "fax_number": "309-661-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N REGENCY DR",
            "address_2": "SUITE 3",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013505",
            "telephone_number": "309-661-0406",
            "fax_number": "309-661-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARAH DUTTA, OB-GYN, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "DUTTA",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "309-661-0406",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-113555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cedric Joshua Sanders
• Adam D Sangston
• Erin Michelle Sansotta
• Joseph A Santiago Jr., M.D.
• Sara Thompson Counseling PLLC
• Sarah L. Swanlund, DMD, Inc.
• Randi L Sassano
• Jennifer Kristin Satchwell, MSW
• Elizabeth A Saunches, APN
• Lucas Sawisch

• Obstetrics & Gynecology Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.