Individual provider Active NPI

Rufus Edgar Sadler, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1316935406
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
163783 Issued in NY
Practice address
3750 Third Ave
DMG
Bronx, NY 10456-2102
Phone
(718) 588-0100
Fax
(646) 568-2982
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 163783 NY Primary

Addresses

Primary practice location

3750 Third Ave
DMG
Bronx, NY 10456-2102

Mailing address

392 Bedford Park Blvd
Bronx, NY 10458-2415
Phone (718) 364-0100

Other identifiers 4

IdentifierTypeStateIssuer
MA45747OtherNJLICENSE NUMBER
00909462OtherNYMEDICAID PROVIDER NUMBER
163783OtherNYLICENSE
53D771OtherNYMEDICARE PROVIDER NUMBER

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
163783NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Womens OB GYN Care at the Pavilion PC Past Accepting new patients
Doctor Medical of Ny PC Past Accepting new patients

Organizations & group practices 2

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1316935406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "392 BEDFORD PARK BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104582415",
            "telephone_number": "718-364-0100",
            "fax_number": "718-295-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 THIRD AVE",
            "address_2": "DMG",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104562102",
            "telephone_number": "718-588-0100",
            "fax_number": "646-568-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADLER",
        "first_name": "RUFUS",
        "middle_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "163783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MA45747",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROVIDER NUMBER",
            "identifier": "00909462",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "163783",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "53D771",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.