Individual provider Active NPI

Anthony H Sacks, M.D.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1376556134
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A39026 Issued in CA
Practice address
10243 Genetic Center Dr
San Diego, CA 92121-6310
Phone
(858) 499-2600
Fax
(858) 526-6093
NPI assigned
Aug 14, 2006
Last updated
Jun 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A39026 CA Primary

Addresses

Primary practice location

10243 Genetic Center Dr
San Diego, CA 92121-6310

Mailing address

10243 Genetic Center Dr
San Diego, CA 92121-6310
Phone (858) 499-2600

Other identifiers 1

IdentifierTypeStateIssuer
00A390260MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100730000251 CA Practitioner - Family Practice 1951205095 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A39026CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Sep 1, 1985 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Family Medicine CurrentSince Sep 1, 1985 Accepting new patients

Locations

10243 Genetic Center Dr
San Diego, CA 92121
Phone (858) 499-2704

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

5651 Copley Dr
San Diego, CA 92111
Phone (858) 262-6340

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1376556134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10243 GENETIC CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921216310",
            "telephone_number": "858-499-2600",
            "fax_number": "858-526-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10243 GENETIC CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921216310",
            "telephone_number": "858-499-2600",
            "fax_number": "858-526-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKS",
        "first_name": "ANTHONY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A39026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A390260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.