Logan Alexander Sarge

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PENDING Issued in WI

Practice address

10101 W Wisconsin Ave
Wauwatosa, WI 53226-4861

Phone

(414) 259-6310

NPI assigned

Nov 28, 2019

Last updated

Nov 28, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574899200000",
    "number": "1184261943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2887 S 128TH ST",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514029",
            "telephone_number": "920-251-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 W WISCONSIN AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264861",
            "telephone_number": "414-259-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARGE",
        "first_name": "LOGAN",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-28",
        "last_updated": "2019-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Sandberg, DMD
• Justin Sandver, M.D.
• Hairong Sang, M.D.
• Angie M Santarelli, APNP
• Jose Jesus Santiago-Roque Jr., PA-C
• Asheema Anna Saripalli, MD
• Shreema Sawlani, MD
• Kathryn Jane Scallon, LPC-IT
• Katelyn Schaefer
• Rory Schaeffer

• Physical Medicine & Rehabilitation Physician in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Physical Medicine & Rehabilitation Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.