Sara L Chargo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007627 Issued in MI

Practice address

602 Michigan Ave
Holland, MI 49423-4918

Phone

(616) 546-4950

NPI assigned

Jan 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sara L Kordupel Other name

Medicare fee-for-service enrollment

Enrolled in MI, SD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Holland Community Hospital

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holland, MI
  • NPI 1780888099

  MI

  Medicare reassignment
• Sanford Clinic

  • Psychologist
  • Sioux Falls, SD
  • NPI 1396764254

  SD

  Medicare reassignment
• Holland Community Hospital

  • Hospitalist Physician
  • Holland, MI
  • NPI 1497090617

  Physician Assistant

  NPD
• Holland Community Hospital

  • Family Medicine Physician
  • Hudsonville, MI
  • NPI 1952130585

  Physician Assistant

  NPD
• Sanford Clinic

  • Diagnostic Radiology Physician
  • Fargo, ND
  • NPI 1306641345
  NPD
• Sanford Clinic

  • Clinical Medical Laboratory
  • Sioux Falls, SD
  • NPI 1346410115
  NPD

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1023474178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234918",
            "telephone_number": "616-546-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARGO",
        "first_name": "SARA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-05",
        "last_updated": "2023-12-22",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "KORDUPEL",
            "middle_name": "L",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Abigail Grace Chamberlain
• David W. Chamness, MD
• Kristen Taylor Chan
• Megan Chan
• Leann Chanthala
• Charis
• Kelley Charles, LLMSW
• Chase - Edward Inc.
• Michael A Cheek, M.D.
• Beth E Cherin, MA, LPC, NCC

• All providers in Holland, MI
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.

Verify at the official NPI Registry.