Individual provider Active NPI

Jackson L Saddemi, MD

  • Ophthalmology Physician
  • Philadelphia, PA
National Provider Identifier
1780320648
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD493678 Issued in PA
Practice address
840 Walnut St Ste 1435
Philadelphia, PA 19107-5180
Phone
(215) 928-3130
Fax
(215) 592-1923
NPI assigned
May 12, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuro-ophthalmology Physician 207WX0109X MD493678 PA
Ophthalmology Physician 207W00000X MD493678 PA Primary

Addresses

Primary practice location

840 Walnut St Ste 1435
Philadelphia, PA 19107-5180

Mailing address

840 Walnut St Ste 1435
Philadelphia, PA 19107-5180
Phone (215) 928-3130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20260522000051 PA Practitioner - Ophthalmology 6608346465

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Cooper Medical School of Rowan University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wills Eye Ophthalmology Clinic, IncGroup PAC ID 9133025166, 146 clinicians

Practice addresses (Care Compare)

840 Walnut St
Philadelphia, PA 19107-5109
Phone (215) 928-3041

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1780320648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST STE 1435",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075180",
            "telephone_number": "215-928-3130",
            "fax_number": "215-592-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST STE 1435",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075180",
            "telephone_number": "215-928-3130",
            "fax_number": "215-592-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADDEMI",
        "first_name": "JACKSON",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-12",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0109X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": "PA",
            "license": "MD493678",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD493678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.