Individual provider Active NPI

Stephen Alan Sachs, D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Lake Success, NY
National Provider Identifier
1437114931
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
028490 Issued in NY
Practice address
2001 Marcus Ave
Ste. N-10
Lake Success, NY 11042-1011
Phone
(516) 775-1818
Fax
(516) 775-0892
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 028490 NY
Oral and Maxillofacial Pathology Dentistry 1223P0106X 028490 NY
Oral and Maxillofacial Radiology Dentistry 1223X0008X 028490 NY
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 028490 NY
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 028490 NY Primary

Addresses

Primary practice location

2001 Marcus Ave
Ste. N-10
Lake Success, NY 11042-1011

Mailing address

2001 Marcus Ave
Ste. N-10
Lake Success, NY 11042-1011
Phone (516) 775-1818

Other identifiers 1

IdentifierTypeStateIssuer
00501157MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20061030000308 NY Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 4587661137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 Marcus Ave
Suite N10
New Hyde Park, NY 11042-2048
Phone (516) 775-1818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oms New York Oral Surgery PC Oral and Maxillofacial Surgery PastSince Aug 28, 2022 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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1437114931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "STE. N-10",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-775-1818",
            "fax_number": "516-775-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "STE. N-10",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-775-1818",
            "fax_number": "516-775-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACHS",
        "first_name": "STEPHEN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "028490",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "028490",
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "NY",
            "license": "028490",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "028490",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "028490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00501157",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Success, NY

Sources for this page

Verify at the official NPI Registry.