BRYAN SHANLEY SACK (M.D.) – Pediatric Urology Physician, NPI 1487979951
Pediatric Urology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
568 UROLOGY in OH
Provider Addresses for BRYAN SHANLEY SACK (M.D.)
555 S 18th St
Columbus, OH 432052654
Phone: (614) 722-2000
Type: Location
7853 Pacer Dr
Delaware, OH 430157571
Phone: (614) 722-2000
Type: Location
536 S Trimble Rd
Mansfield, OH 449063418
Phone: (614) 722-2000
Type: Location
455 Executive Campus Dr
Westerville, OH 430828870
Phone: (614) 722-2000
Type: Location
5675 Venture Dr
Dublin, OH 430172159
Phone: (614) 722-2000
Type: Location
700 Childrens Dr
Columbus, OH 432052664
Phone: (614) 722-2000
Type: Location
8930 Ohio River Rd
Wheelersburg, OH 456941922
Phone: (614) 722-2000
Type: Location
1500 East Medical Center Dr
4th floor Clinic B CS Mott Childrens Hosp Rm 4807
Ann Arbor, MI 481094217
Phone: (734) 936-7030
Fax: (734) 615-3520
Type: Location
4126 N Holland Sylvania Rd Ste 220
Toledo, OH 436233537
Phone: (419) 517-7658
Type: Location
3020 N McCord Rd
Toledo, OH 436151702
Phone: (419) 517-7658
Type: Location
4363 All Seasons Dr
Hilliard, OH 430262050
Phone: (614) 722-2000
Type: Location
830 W High St
Lima, OH 458013971
Phone: (614) 722-2000
Type: Location
405 Butterfly Gardens Dr
Columbus, OH 432153427
Phone: (614) 722-2000
Type: Location
1 Childrens Plz
Dayton, OH 454041873
Phone: (614) 722-2000
Type: Location
7901 Diley Rd
Canal Winchester, OH 431109612
Phone: (614) 722-2000
Type: Location
6435 E Broad St
Columbus, OH 432131507
Phone: (614) 722-2000
Type: Location
26 Hospital Dr
Athens, OH 457012471
Phone: (614) 722-2000
Type: Location
740 Adair Ave
Zanesville, OH 437012838
Phone: (614) 722-2000
Type: Location
2222 CHERRY ST STE 1800
TOLEDO, OH 436082679
Phone: (419) 251-4300
Type: Mailing
South State Street, Ann Arbor, Washtenaw County, Michigan, 48108-1774, United States
ANN ARBOR, MI 481081633
Phone: (734) 647-5299
Type: Mailing
Mott Children's Hospital and Von Voigtlander Women's Hospital, 1500, East Medical Center Drive, Ann Arbor, Washtenaw County, Michigan, 48109, United States
4TH FLOOR CLINIC B CS MOTT CHILDRENS HOSP RM 4807
ANN ARBOR, MI 481094217
Phone: (734) 936-7030
Fax: (734) 615-3520
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $143.
Total Amount is formed as General ($143) + Research ($0) + Ownership ($0) = $143.
Last reported payment date: 2023-03-21 • Largest payer in this snapshot: Boston Scientific Corporation ($126).
Total Amount
$143
General + Research + Ownership
Payments
3
Total payment records
General Amount
$143
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $126 |
| Tandem Diabetes Care, Inc. | $17 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-02-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180717002795 | I | Urology | MI | TBD |
| I20240219003116 | I | Urology | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 43205)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Pediatric Medicine, Urology | OH | |
| Otolaryngology, Urology | OH | |
| Internal Medicine, Pediatric Medicine | OH | |
| Pediatric Medicine, Hospitalist | OH | |
| Cardiovascular Disease (Cardiology), Pediatric Medicine, Pediatric Medicine | OH | |
| O T O L A R Y N G O L O G Y | OH | |
| Nurse Practitioner | OH | |
| Cardiovascular Disease (Cardiology) | OH |
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