Active NPI
Savaglio Family Optometry, LLC
- Optometrist
- Kenosha, WI
National Provider Identifier
1295916849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2831-035
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. David Savaglio, O.D.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071231000548 | WI | Part B Supplier - Clinic/Group Practice | 6709966872 |
Receives reassigned benefits from 1 practitioner Practice locations: Kenosha, WI |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Optometrist
- Kenosha, WI
- NPI 1366584088
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.