Active NPI
George Sack, M.D.
- Internal Medicine Physician
- Baltimore, MD
National Provider Identifier
1710912910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D13190
- Practice address
- 600 N Wolfe St
Baltimore, MD 21287-0005 - Phone
- (410) 955-9434
- NPI assigned
- Jul 12, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D13190 | MD | Primary |
Addresses
Primary practice location
600 N Wolfe St
Baltimore, MD 21287-0005
Mailing address
PO Box 64264
Baltimore, MD 21264-4264
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 712761800 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170314000453 | MD | Order and Referring Only - Medical Genetics and Genomics | 4981989902 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710912910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64264",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212644264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N WOLFE ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212870005",
"telephone_number": "410-955-9434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACK",
"first_name": "GEORGE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D13190",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "712761800",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.