MEDICARE: DR. STANLEY P. SADY M.D. , PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	DR.0057730	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	NM009C89	OTHER	NM	BLUE CROSS BLUE SHEILD
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	961251	OTHER	NM	PRONET / AETNA

General Provider Information

NPI Number	:	1235132606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY P. SADY M.D. , PHD

Provider Business Mailing Address
First Line	:	1400 E BOULDER ST
Second Line	:	PSSB SUITE 1200
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-5533
Country	:	US
Telephone Number	:	719-365-6999
Fax Number	:

Provider Business Practice Location Address
First Line	:	4150 V ST
Second Line	:	PSSB SUITE 1200
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-1460
Country	:	US
Telephone Number	:	916-734-7985
Fax Number	:	916-734-2975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	02/01/2017

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Directions to “ DR. STANLEY P. SADY M.D. , PHD” Practice Location

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