Organization Active NPI

Sage Medical Group, Inc.

  • Geriatric Medicine (Family Medicine) Physician
  • Canoga Park, CA
National Provider Identifier
1528962925
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
SAGE MEDICAL GROUP, INC.
Practice address
20935 Vanowen St Ste 203
Canoga Park, CA 91303-3806
Phone
(747) 325-4293
Fax
(747) 240-4013
NPI assigned
Oct 7, 2026
Last updated
Oct 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Authorized official

Name
Ivy Bellezo
Title
Office Manager
Phone
(747) 213-7483

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Primary Care Nurse Practitioner 363LP2300X
Geriatric Medicine (Family Medicine) Physician 207QG0300X Primary
General Practice Physician 208D00000X

Addresses

Primary practice location

20935 Vanowen St Ste 203
Canoga Park, CA 91303-3806

Mailing address

20935 Vanowen St Ste 203
Canoga Park, CA 91303-3806
Phone (747) 325-4293

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1791331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1528962925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20935 VANOWEN ST STE 203",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033806",
            "telephone_number": "747-325-4293",
            "fax_number": "747-240-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20935 VANOWEN ST STE 203",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033806",
            "telephone_number": "747-325-4293",
            "fax_number": "747-240-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-07",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "BELLEZO",
        "authorized_official_first_name": "IVY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "747-213-7483"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; 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.