BRYAN SHANLEY SACK M.D. NPI 1487979951

NPI Information

  • NPI: 1487979951
  • Provider Name: BRYAN SHANLEY SACK, M.D.
  • Classification: Urology - 2088P0231X
  • Specialization: Pediatric Urology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2222 CHERRY ST STE 1800
    TOLEDO, OH
    ZIP 43608
  • Phone: (419) 251-4300

Map and Directions

Get Directions

NPI Details

Bryan Shanley Sack, M.D. is a pediatric urology urology in Toledo, OH with 16 years of experience. The provider is surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). Bryan Shanley Sack, M.D. NPI is 1487979951. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2010

The provider's business location address is:

2222 CHERRY ST STE 1800
TOLEDO, OH
ZIP 43608-679
Phone: (419) 251-4300

The NPI 1487979951 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/29/2010 and was last updated on 11/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208800000XUrology4301114274MICHIGANNo
2208800000XUrology35.149791OHIONo
32088P0231XUrologyPediatric Urology4301114274MICHIGANNo
42088P0231XUrologyPediatric Urology35.149791OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H0024826-CSAOTHEROHIOCGS
20433417MEDICAIDOHIO
3H0013934-NWPSOTHEROHIOCGS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI