Individual provider Active NPI

Sonia P Salazar, PA-C

  • Physician Assistant
  • Mequon, WI
National Provider Identifier
1124460365
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3166-23 Issued in WI
Practice address
6425 W Mequon Rd
Mequon, WI 53092-1862
Phone
(262) 387-8200
NPI assigned
Jul 29, 2013
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3166-23 WI Primary

Addresses

Primary practice location

6425 W Mequon Rd
Mequon, WI 53092-1862

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

2323 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 290-6720

Other identifiers 1

IdentifierTypeStateIssuer
100032216MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ssalazar406947@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130911000550 WI Practitioner - Physician Assistant 0941444079 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

3289 N Mayfair Rd
Wauwatosa, WI 53222-3203
Phone (414) 771-7900

6425 W Mequon Rd
Mequon, WI 53092-1855
Phone (262) 242-0051

Merit-based Incentive Payment System (MIPS)

Final score
99.02 of 100Reported as apm
Quality
85.37
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3166-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Aug 9, 2024 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Aug 9, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 9, 2024 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Aug 9, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 9, 2024 Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

6425 W Mequon Rd
Mequon, WI 53092
Phone (262) 242-0051

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

3237 S 16th St
Milwaukee, WI 53215
Phone (414) 647-5000

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

Interoperability endpoints

  • Direct secure messaging: ssalazar406947@direct.myadvocateaurora.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1124460365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 W MEQUON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530921862",
            "telephone_number": "262-387-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2323 N Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532114508",
            "country_code": "US",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "SONIA",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3166-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100032216",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssalazar406947@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6425 W Mequon Rd",
            "city": "Mequon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530921862",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6425 W Mequon Rd",
            "city": "Mequon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530921862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.