Bryan Shanley Sack, M.D.

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

35.149791 Issued in OH

Practice address

2222 Cherry St Ste 1800
Toledo, OH 43608-2679

Phone

(419) 251-4300

NPI assigned

Mar 29, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI, OH2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations (25 of 31)

Interoperability endpoints

• Direct secure messaging: bsack720345@direct.med.umich.edu
• Direct secure messaging: bsack2520234@direct.bsmhealth.org
• FHIR API: https://api.platform.athenahealth.com/2229/brand/3/csg/621/fhir/r4
• FHIR API: https://hkc.nationwidechildrens.org/FHIR/MYCHART/api/FHIR/R4

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.

• Children'S Surgical Associates, Corporation

  • Pediatric Surgery Physician
  • Columbus, OH
  • NPI 1417905324
  Medicare reassignment NPD
• Nationwide Children'S Hospital

  • Multi-Specialty Clinic/Center
  • Columbus, OH
  • NPI 1851179873
  Medicare reassignment NPD
• Northwest Pediatric Specialists, LLC

  • Pediatrics Physician
  • Toledo, OH
  • NPI 1033709100
  Medicare reassignment NPD
• Promedica Children'S Specialists

  • Pediatrics Physician
  • Toledo, OH
  • NPI 1245444959
  Medicare reassignment NPD
• Edward W. Sparrow Hospital Association

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088
  Medicare reassignment NPD
• Metropolitan Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment NPD
• Regents of the University of Michigan

  • Urology Physician
  • Ann Arbor, MI
  • NPI 1437184884
  Medicare reassignment NPD
• Nationwide Children'S Hospital

  • Durable Medical Equipment & Medical Supplies
  • Columbus, OH
  • NPI 1447061262
  NPD
• Edward W Sparrow Hospital Association

  • Adult Health Nurse Practitioner
  • Lansing, MI
  • NPI 1265220438
  NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1487979951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 CHERRY ST STE 1800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082679",
            "telephone_number": "419-251-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 CHERRY ST STE 1800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082679",
            "telephone_number": "419-251-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4363 All Seasons Dr",
            "address_purpose": "LOCATION",
            "city": "Hilliard",
            "state": "OH",
            "postal_code": "430262050",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8930 Ohio River Rd",
            "address_purpose": "LOCATION",
            "city": "Wheelersburg",
            "state": "OH",
            "postal_code": "456941922",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4126 N Holland Sylvania Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436233537",
            "country_code": "US",
            "telephone_number": "419-517-7658",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5675 Venture Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430172159",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Executive Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828870",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "536 S Trimble Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449063418",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7853 Pacer Dr",
            "address_purpose": "LOCATION",
            "city": "Delaware",
            "state": "OH",
            "postal_code": "430157571",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 S 18th St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052654",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 Diley Rd",
            "address_purpose": "LOCATION",
            "city": "Canal Winchester",
            "state": "OH",
            "postal_code": "431109612",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "830 W High St",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458013971",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432153427",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Plz",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454041873",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6435 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432131507",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 East Medical Center Dr",
            "address_2": "4th floor Clinic B CS Mott Childrens Hosp Rm 4807",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481094217",
            "country_code": "US",
            "telephone_number": "734-936-7030",
            "fax_number": "734-615-3520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3020 N McCord Rd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436151702",
            "country_code": "US",
            "telephone_number": "419-517-7658",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "740 Adair Ave",
            "address_purpose": "LOCATION",
            "city": "Zanesville",
            "state": "OH",
            "postal_code": "437012838",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "457012471",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SACK",
        "first_name": "BRYAN",
        "middle_name": "SHANLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-29",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301114274",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35.149791",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "MI",
            "license": "4301114274",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "OH",
            "license": "35.149791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CGS",
            "identifier": "H0024826-CSA",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0433417",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CGS",
            "identifier": "H0013934-NWPS",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ogieorumuah Sabageh, DDS
• Jaimee Leigh Sabatino
• Kelsi Erinn Sabbagh, PA-C
• Syeda Tanaaz Saberi
• Diane Saccone, R.PH.
• Stephen Saddemi, M.D.
• Evon Renee Saddler
• Reza Sadeghian, M.D.
• Kelly M Sadowski, PA-C
• Scott Robert Sadowski, O.D.

• Pediatric Urology Physician in Toledo, OH
• Providers in Toledo, OH by specialty
• Pediatric Urology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.