Timothy A. Sanborn, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

69326 Issued in WI

Practice address

6308 8TH Ave
Kenosha, WI 53143

Phone

(262) 653-3650

Fax

(262) 656-3672

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)

Education

Northwestern University Feinberg Medical School, 1977

Medicare assignment

May accept Medicare assignment

Group practices

Kenosha Community Health Center, Inc.Group PAC ID 0941195168, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tsanborn642754@direct.ochin.org

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.

• Kenosha Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kenosha, WI
  • NPI 1265435960
  Medicare reassignment Care Compare group NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• Kenosha Community Health Center, Inc

  dba Pillar Health

  • Federally Qualified Health Center (FQHC)
  • Kenosha, WI
  • NPI 1710635677
  NPD
• Kenosha Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Racine, WI
  • NPI 1215823406
  NPD
• Liz Hanson Will, LLC

  dba Therapy Solutions

  • Clinical Social Worker
  • Mount Pleasant, WI
  • NPI 1043888902
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1073600987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 S 6TH ST",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542010",
            "telephone_number": "414-346-8000",
            "fax_number": "414-346-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53143",
            "telephone_number": "262-653-3650",
            "fax_number": "262-656-3672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2050 Pfingsten Rd",
            "address_2": "Suite 360",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600261324",
            "country_code": "US",
            "telephone_number": "847-657-1819",
            "fax_number": "847-657-1898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Oak Creek",
            "state": "WI",
            "postal_code": "531542010",
            "country_code": "US",
            "telephone_number": "414-346-8000",
            "fax_number": "414-346-8010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9555 76th St",
            "address_purpose": "LOCATION",
            "city": "Pleasant Prairie",
            "state": "WI",
            "postal_code": "531581984",
            "country_code": "US",
            "telephone_number": "262-656-3650",
            "fax_number": "262-656-3672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANBORN",
        "first_name": "TIMOTHY",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036102493",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "69326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073600987",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana M Saitis, MD
• Farah Salahuddin, MD
• Genivieve Salata, LPC
• Robert C. Salituro, D.D.S
• Sams East Inc (Sam's Pharmacy 10-6331)
• Manuel Alejandro Sanchez, PHYSICIAN ASSISTANT
• Lawrence C Sandberg, PT
• Sydney Sanders
• Marie Lynn Sands, PTA
• Daniel R Santarelli, DDS

• Cardiovascular Disease Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Cardiovascular Disease Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.