Eric J Sacknoff, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

0101239642 Issued in VA

Practice address

2900 1St Ave Ste 230
Huntington, WV 25702-1241

Phone

(304) 525-3711

Fax

(304) 525-2748

NPI assigned

Jul 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St. Mary'S Medical Management, LLC

  • Family Medicine Physician
  • Huntington, WV
  • NPI 1922155217

  Urology

  Medicare reassignment NPD
• St. Mary'S Medical Management, LLC

  • Orthopaedic Surgery Physician
  • Huntington, WV
  • NPI 1205596665
  NPD

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1295734598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4190",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255044190",
            "telephone_number": "304-908-9202",
            "fax_number": "304-399-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 1ST AVE STE 230",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021241",
            "telephone_number": "304-525-3711",
            "fax_number": "304-525-2748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5950 University Ave Ste 341",
            "address_purpose": "LOCATION",
            "city": "West Des Moines",
            "state": "IA",
            "postal_code": "502668289",
            "country_code": "US",
            "telephone_number": "515-875-9800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Snider St",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "VA",
            "postal_code": "243544221",
            "country_code": "US",
            "telephone_number": "276-783-5400",
            "fax_number": "276-783-5521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SACKNOFF",
        "first_name": "ERIC",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IA",
            "license": "MD-46056",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101239642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010281067",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "463937",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "199795",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01081069",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295734598",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rivierra Ryan
• Kyle Garrett Ryder
• Barbara Ryerson
• Paula K. Rymer, MSW, LICSW
• Kathy L Saber, M.D.
• Yasamin Asal Sadeghian
• Robin Sadler
• Samiyah Sadullah, MD
• Safe RX Pharmacies Inc
• Steven Sagle

• Urology Physician in Huntington, WV
• Providers in Huntington, WV by specialty
• Urology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.