NPIMap

Individual provider Active NPI

Charles Martin Sackmann, MD

  • Family Medicine Physician
  • Ritzville, WA
National Provider Identifier
1396759635
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00027448 Issued in WA
Practice address
210 W. Main
Ritzville, WA 99169-0438
Phone
(509) 659-4800
Fax
(509) 659-4801
NPI assigned
Jul 29, 2006
Last updated
Feb 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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 MD00027448 WA Primary

Addresses

Primary practice location

210 W. Main
Ritzville, WA 99169-0438

Mailing address

P.O. Box 438
Ritzville, WA 99169-0438
Phone (509) 659-4800

Other identifiers 2

IdentifierTypeStateIssuer
0050906OtherWAWA L&I
8119547MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060118000744 WA Practitioner - Family Practice 6204850191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hometown Family Medicine PSGroup PAC ID 8426232695, 2 clinicians

Practice addresses (Care Compare)

210 W Main Ave
Ritzville, WA 99169-1410
Phone (509) 659-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.32 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
77.73

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Family Medicine PS CurrentSince Feb 13, 2011 Accepting new patients
Lake Girl, Inc Past Accepting new patients

Locations

210 W Main Ave
Ritzville, WA 99169
Phone (509) 659-4800

903 S Adams St
Ritzville, WA 99169
Phone (509) 659-1200

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1396759635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 438",
            "city": "RITZVILLE",
            "state": "WA",
            "postal_code": "991690438",
            "telephone_number": "509-659-4800",
            "fax_number": "509-659-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W. MAIN",
            "city": "RITZVILLE",
            "state": "WA",
            "postal_code": "991690438",
            "telephone_number": "509-659-4800",
            "fax_number": "509-659-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKMANN",
        "first_name": "CHARLES",
        "middle_name": "MARTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00027448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "0050906",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8119547",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ritzville, WA

Sources for this page

Verify at the official NPI Registry.