Active NPI
Gregory M Saracco, MD
- Surgery Physician
- Wheeling, WV
National Provider Identifier
1902956048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 16191
- Practice address
- 2115 Chapline St
Suite 308
Wheeling, WV 26003-3859 - Phone
- (304) 234-8300
- Fax
- (304) 233-6073
- NPI assigned
- Jan 11, 2007
- Last updated
- Jul 8, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 16191 | WV | Primary |
| Surgery Physician | 208600000X | 35053534 | OH |
Addresses
Primary practice location
2115 Chapline St
Suite 308
Wheeling, WV 26003-3859
Mailing address
PO Box 6922
Wheeling, WV 26003-0929
Phone (304) 233-2455
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0124865000 | Medicaid | WV | |
| 0634353 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 572 | WV | MD | Professional Counselor |
| 35053534 | OH | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Secours Medical Group Hampton Roads Specialty Care LLC | Current | Accepting new patients | |
| Bon Secours Medical Group Hampton Roads Specialty Care LLC | Surgery | Current | Accepting new patients |
| Ohio Valley Medical Center Inc | Past | Accepting new patients | |
| Wheeling Surgical Associates, Inc. | Surgery | Past | Accepting new patients |
Locations
150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944
8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- NPI 1629637475
Surgery
-
- Family Medicine Physician
- Wheeling, WV
- NPI 1861699829
-
- Surgery Physician
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902956048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6922",
"city": "WHEELING",
"state": "WV",
"postal_code": "260030929",
"telephone_number": "304-233-2455",
"fax_number": "304-233-6073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 CHAPLINE ST",
"address_2": "SUITE 308",
"city": "WHEELING",
"state": "WV",
"postal_code": "260033859",
"telephone_number": "304-234-8300",
"fax_number": "304-233-6073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARACCO",
"first_name": "GREGORY",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WV",
"license": "16191",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "35053534",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0124865000",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0634353",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wheeling, WV
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.