NPIMap

Organization Active NPI

Frederick J Sauerburger MD PA

  • Ophthalmology Physician
  • Waldorf, MD
National Provider Identifier
1588660385
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
KN29 Issued in MD
Legal business name
FREDERICK J SAUERBURGER MD PA
Practice address
11345 Pembrooke Square
Ste 105
Waldorf, MD 20603
Phone
(301) 843-3120
Fax
(301) 645-4740
NPI assigned
Jun 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Dr. Frederick J Sauerburger, MDNPI 1538163514
Title
President
Phone
(301) 843-3120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 212291000 MD
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X KN29 MD Primary

Addresses

Primary practice location

11345 Pembrooke Square
Ste 105
Waldorf, MD 20603

Mailing address

11345 Pembrooke Square
Ste 105
Waldorf, MD 20603
Phone (301) 843-3120

Other identifiers 3

IdentifierTypeStateIssuer
8185OtherDCCAREFIRST OF DC
212291000MedicaidMD
KN29FROtherMDCAREFIRST OF MD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091204000107 MD Part B Supplier - Clinic/Group Practice 5991844979 Receives reassigned benefits from 2 practitioners
Practice locations: Waldorf, MD
O20150211000110 DC Part B Supplier - Clinic/Group Practice 5991844979 Receives reassigned benefits from 1 practitioner
Practice locations: Bowie, MD; Waldorf, MD

National Provider Directory

National Provider Directory

Locations

11345 Pembrooke Sq
Waldorf, MD 20603

11345 Pembrooke Sq
Ste 105
Waldorf, MD 20603
Phone (301) 645-8120

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1588660385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11345 PEMBROOKE SQUARE",
            "address_2": "STE 105",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "20603",
            "telephone_number": "301-843-3120",
            "fax_number": "301-645-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11345 PEMBROOKE SQUARE",
            "address_2": "STE 105",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "20603",
            "telephone_number": "301-843-3120",
            "fax_number": "301-645-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK J SAUERBURGER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "SAUERBURGER",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-843-3120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "212291000",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "KN29",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF DC",
            "identifier": "8185",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212291000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF MD",
            "identifier": "KN29FR",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.