Disa Gage Sacks MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0060948 Issued in FL

Legal business name

DISA GAGE SACKS MD PA

Practice address

1282 S US Highway 1
Suite 4
Rockledge, FL 32955-2747

Phone

(321) 632-4800

Fax

(321) 632-6320

NPI assigned

Mar 17, 2010

Organization subpart

No

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

Authorized official

Name

Deborah L Nicoletti, RN

Title

Office Manager

Phone

(321) 632-4800

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Sualeh Kamal Ashraf, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Kissimmee, FL
  • NPI 1457306342
  NPD (past)
• Robert E Barden, M.D.

  • Cardiovascular Disease Physician
  • Rockledge, FL
  • NPI 1043322605
  NPD (past)

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1649594847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1282 S US HIGHWAY 1",
            "address_2": "SUITE 4",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552747",
            "telephone_number": "321-632-4800",
            "fax_number": "321-632-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1282 S US HIGHWAY 1",
            "address_2": "SUITE 4",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552747",
            "telephone_number": "321-632-4800",
            "fax_number": "321-632-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISA GAGE SACKS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "NICOLETTI",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "321-632-4800",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0060948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370893400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Thomas Derrick II, B.S.
• Elisabeth Desmond
• Tabitha Diaz
• Alexa Diec, PHARMD
• Martin Frederik Dietrich, M.D., PH.D.
• Discovering Purpose Mental Healthcare LLC
• Discovery Institute, P.a.
• Natasha Dixon
• Debrina Dobbs
• Howard Drexel Dobson III, MD

• Specialist in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.