Active NPI
Jacek Sakowski, M.D.
- Pediatric Adolescent Medicine Physician
- Hackettstown, NJ
National Provider Identifier
1699774513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 25MA07614800
- Practice address
- 4C Doctors Park
Hackettstown, NJ 07840-1716 - Phone
- (908) 852-8096
- Fax
- (908) 852-5012
- NPI assigned
- Jul 21, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 25MA07614800 | NJ | Primary |
Addresses
Primary practice location
4C Doctors Park
Hackettstown, NJ 07840-1716
Mailing address
117 Seber Rd
BLD 4 Suite C
Hackettstown, NJ 07840-1722
Phone (908) 852-8096
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0121193 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA07614800 | NJ | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackettstown Pediatrics, LLC | Adolescent Medicine | Past | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | 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.
-
- Pediatric Adolescent Medicine Physician
- Hackettstown, NJ
- NPI 1316211915
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565654400000",
"number": "1699774513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 SEBER RD",
"address_2": "BLD 4 SUITE C",
"city": "HACKETTSTOWN",
"state": "NJ",
"postal_code": "078401722",
"telephone_number": "908-852-8096",
"fax_number": "908-852-5012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4C DOCTORS PARK",
"city": "HACKETTSTOWN",
"state": "NJ",
"postal_code": "078401716",
"telephone_number": "908-852-8096",
"fax_number": "908-852-5012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAKOWSKI",
"first_name": "JACEK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-21",
"last_updated": "2019-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "NJ",
"license": "25MA07614800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0121193",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hackettstown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.