Individual provider Active NPI

Herman Marx Sacks, D.O.

  • Family Medicine Physician
  • D'Iberville, MS
National Provider Identifier
1730159369
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-422 Issued in AL
Practice address
3661 Sangani Blvd Ste E
Diberville, MS 39540-8707
Phone
(228) 354-0022
Fax
(228) 354-0088
NPI assigned
Jan 25, 2006
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO-422 AL Primary

Addresses

Primary practice location

3661 Sangani Blvd Ste E
Diberville, MS 39540-8707

Mailing address

15571 Stewart Rd
Biloxi, MS 39532-6078
Phone (228) 209-0928

Other practice location 1

509 Liberty Rd Ste C
Flowood, MS 39232-8047
Phone (601) 665-2396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211214002162 AL Practitioner - Emergency Medicine 9830490754 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO-422ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maxem Health Urgent Care Mobile CurrentSince Jan 1, 2022 Accepting new patients
Purpose & Power Healthcare Services, LLC PastSince May 12, 2024 Accepting new patients
South Mississippi Urgent Care PastSince Sep 1, 2010 Accepting new patients

Locations

535 Schillinger Rd S
#A
Mobile, AL 36695
Phone (251) 544-6611

Interoperability endpoints

  • Direct secure messaging: herman.sacks.1@3362.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1730159369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15571 STEWART RD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395326078",
            "telephone_number": "228-209-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 SANGANI BLVD STE E",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395408707",
            "telephone_number": "228-354-0022",
            "fax_number": "228-354-0088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 Liberty Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Flowood",
            "state": "MS",
            "postal_code": "392328047",
            "country_code": "US",
            "telephone_number": "601-665-2396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SACKS",
        "first_name": "HERMAN",
        "middle_name": "MARX",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO-422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in D'Iberville, MS

Sources for this page

Verify at the official NPI Registry.