Jack Sadacka, M.D

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

231797 Issued in NY

Practice address

813 Quentin Rd Ste 202
Brooklyn, NY 11223-2220

Phone

(718) 645-2618

Fax

(718) 645-2641

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: jacksadacka@mai.allscriptsdirect.net

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.

• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD
• Maimonides Medical Center - MMC Emergency Physicians FPP

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1982708202
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1356424915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 AVENUE R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292427",
            "telephone_number": "718-336-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 QUENTIN RD STE 202",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112232220",
            "telephone_number": "718-645-2618",
            "fax_number": "718-645-2641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4802 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112192916",
            "country_code": "US",
            "telephone_number": "718-283-8399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SADACKA",
        "first_name": "JACK",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "231797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd C. Sacktor, M.D.
• Benzion Sacolick, MD
• Sacred Self-Love Counseling LCSW PC
• Sacred Silence Acupunture PLLC
• Sacred Spaces a Center for Mindful Transformation
• Sadaka Medical Office PLLC
• Divya Sadana, PHD
• Shiva Sadat Barikani
• Sayed Faheem Sadat, RPA-C
• Jeffrey Sadaya

• Pediatric Adolescent Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatric Adolescent Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; 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.