Organization Active NPI

Savaglio Family Optometry, LLC

  • Optometrist
  • Kenosha, WI
National Provider Identifier
1295916849
Registry record updated Dec 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2831-035 Issued in WI
Legal business name
SAVAGLIO FAMILY OPTOMETRY, LLC
Practice address
3916 67TH Street
Kenosha, WI 53142-3808
Phone
(262) 657-7851
Fax
(262) 657-7852
NPI assigned
Nov 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2008

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

Authorized official

Name
Dr. David Savaglio, O.D.NPI 1366584088
Title
Owner/Member
Phone
(262) 652-3648

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2831-035 WI Primary

Addresses

Primary practice location

3916 67TH Street
Kenosha, WI 53142-3808

Mailing address

3916 67TH Street
Kenosha, WI 53142-3808
Phone (262) 657-7851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071231000548 WI Part B Supplier - Clinic/Group Practice 6709966872 Receives reassigned benefits from 1 practitioner
Practice locations: Kenosha, WI

National Provider Directory

National Provider Directory

Locations

3916 67th St
Lowr
Kenosha, WI 53142
Phone (262) 657-7850

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1295916849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 67TH STREET",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423808",
            "telephone_number": "262-657-7851",
            "fax_number": "262-657-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 67TH STREET",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423808",
            "telephone_number": "262-657-7851",
            "fax_number": "262-657-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAVAGLIO FAMILY OPTOMETRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "SAVAGLIO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "262-652-3648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2831-035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.