Individual provider Active NPI

Brent Donald Sarauer, PA-C

  • Physician Assistant
  • Chippewa Falls, WI
National Provider Identifier
1407330475
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4518-23 Issued in WI
Practice address
2449 County Highway I
Chippewa Falls, WI 54729-4410
Phone
(833) 617-3415
NPI assigned
Sep 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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 4518-23 WI Primary

Addresses

Primary practice location

2449 County Highway I
Chippewa Falls, WI 54729-4410

Mailing address

2449 County Highway I
Chippewa Falls, WI 54729-4410
Phone (833) 617-3415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jun 18, 2024 through Jun 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4518WIMDOrthodontics and Dentofacial Orthopedic Dentist
4518-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reformedicine, S.C. PastSince Sep 8, 2024 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1407330475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2449 COUNTY HIGHWAY I",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547294410",
            "telephone_number": "833-617-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2449 COUNTY HIGHWAY I",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547294410",
            "telephone_number": "833-617-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARAUER",
        "first_name": "BRENT",
        "middle_name": "DONALD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-17",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4518-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

Verify at the official NPI Registry.