Individual provider Active NPI

Sabreen Sarsour, NP

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1174252704
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11802 Issued in WI
Practice address
803 W Layton Ave
Milwaukee, WI 53221-2426
Phone
(414) 939-4411
NPI assigned
Jun 8, 2022
Last updated
Jun 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11802 WI Primary

Addresses

Primary practice location

803 W Layton Ave
Milwaukee, WI 53221-2426

Mailing address

451 W Swan Cercle Apt 2813
Oak Creek, WI 53154-8315

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL MCHC

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
I20220817003782 WI Practitioner - Nurse Practitioner 7012390412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Muslim Community and Health Center of Wisconsin Inc.Group PAC ID 7618258062, 17 clinicians

Practice addresses (Care Compare)

803 W Layton Ave
Milwaukee, WI 53221-2426
Phone (414) 939-4411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11802WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Podiatry Services CurrentSince Jun 20, 2022 Accepting new patients
Muslim Community and Health Center of Wisconsin Inc CurrentSince Aug 1, 2022 Accepting new patients

Locations

803 W Layton Ave
Milwaukee, WI 53221
Phone (414) 253-8330

Interoperability endpoints

  • Direct secure messaging: ssarsour724221@direct.ochin.org

Organizations & group practices 2

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": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1174252704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 W SWAN CERCLE APT 2813",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531548315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 W LAYTON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212426",
            "telephone_number": "414-939-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARSOUR",
        "first_name": "SABREEN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "MCHC",
            "affiliation": "N",
            "address_1": "803 W Layton Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532212426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.