Individual provider Active NPI

Gina Nicole Sacks, MD

  • Plastic Surgery Physician
  • Little Rock, AR
National Provider Identifier
1306295266
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
E-18420 Issued in AR
Practice address
1 Childrens Way # 210
Little Rock, AR 72202-3500
Phone
(501) 364-1479
Fax
(501) 364-3667
NPI assigned
Jun 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X E-18420 AR Primary

Addresses

Primary practice location

1 Childrens Way # 210
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20240921000258 AR Practitioner - Plastic and Reconstructive Surgery 2769773035 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Washington University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Childrens Professional Services Organization LLCGroup PAC ID 4688183148, 180 clinicians

Practice addresses (Care Compare)

1 Childrens Way
Little Rock, AR 72202-3500
Phone (501) 364-2526

Merit-based Incentive Payment System (MIPS)

Final score
97.61 of 100Reported as apm
Quality
77.33
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Childrens Hospital CurrentSince Aug 15, 2024 Accepting new patients
University of Arkansas for Medical Sciences Plastic Surgery Current Accepting new patients
Arkansas Children'S Hospital CurrentSince Aug 15, 2024 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 15, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 15, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 15, 2024 Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients

Locations

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Ste 653
Little Rock, AR 72202

1 Childrens Way
#210
Little Rock, AR 72202
Phone (501) 364-1635

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

2601 Gene George Blvd
Springdale, AR 72762
Phone (479) 725-6800

Organizations & group practices 9

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": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1306295266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 210",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1479",
            "fax_number": "501-364-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKS",
        "first_name": "GINA",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AR",
            "license": "E-18420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.