Individual provider Active NPI

Daniel Christian Sackman, M.D.

  • Urology Physician
  • Tacoma, WA
National Provider Identifier
1730447731
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD60745962 Issued in WA
Practice address
3124 South 19TH St #C320
Tacoma, WA 98405-3011
Phone
(253) 301-5100
Fax
(253) 301-5101
NPI assigned
Apr 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD60745962 WA Primary

Addresses

Primary practice location

3124 South 19TH St #C320
Tacoma, WA 98405-3011

Mailing address

4440 Lindell Blvd
Apt 1503
Saint Louis, MO 63108-2449
Phone (208) 941-7411

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20171016003324 WA Practitioner - Urology 4183869027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Saint Louis University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

17700 SE 272ND St
Covington, WA 98042-4951
Phone (253) 372-7030

222 State Ave N
Kent, WA 98030-4544
Phone (253) 372-7788

311 S L St
Tacoma, WA 98405-3720

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-1962

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60745962WAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Sep 18, 2017 Accepting new patients
Multicare Health System CurrentSince Sep 18, 2017 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

17700 SE 272nd St
#260
Kent, WA 98042

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

3124 S 19th St
Ste C320
Tacoma, WA 98405
Phone (253) 301-5100

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1730447731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 LINDELL BLVD",
            "address_2": "APT 1503",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082449",
            "telephone_number": "208-941-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 SOUTH 19TH ST #C320",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053011",
            "telephone_number": "253-301-5100",
            "fax_number": "253-301-5101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SACKMAN",
        "first_name": "DANIEL",
        "middle_name": "CHRISTIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD60745962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.