Lia Marie Borja Sabalo, M.D.

Key facts

NPI

1427345396

Entity type

Individual (NPI type 1)

Primary specialty

Neonatal-Perinatal Medicine Physician 2080N0001X

License

67030 (WI)

Practice address

130 2ND St
Neenah, WI 54956-2883

Phone

(920) 969-7900

NPI assigned

Jun 29, 2011

Sex

Female

Sole proprietor

No

Organizations & group practices 6

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.

• Children'S Hospital of Wisconsin, Inc. Children's Hospital · Milwaukee, WI · NPI 1750482022
  NPD (past)
• Thedacare Regional Medical Center-Neenah, Inc. General Acute Care Hospital · Neenah, WI · NPI 1518993880
  NPD (past)
• Enumclaw Regional Hospital Association Critical Access Hospital · Enumclaw, WA · NPI 1073674040
  NPD (past)
• Sutter North Medical Foundation Ambulatory Surgical Clinic/Center · Yuba City, CA · NPI 1144251521
  NPD (past)
• Sutter Valley Hospitals General Acute Care Hospital · Modesto, CA · NPI 1699129601
  NPD (past)
• Sutter Valley Hospitals General Acute Care Hospital · Sacramento, CA · NPI 1811946734
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lsabalo661327@hisp.ehr.sutterhealth.org

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1427345396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-969-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-969-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1506 S Oneida St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549151305",
            "country_code": "US",
            "telephone_number": "920-738-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SABALO",
        "first_name": "LIA MARIE",
        "middle_name": "BORJA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.059343",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "WI",
            "license": "67030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427345396",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Neenah, WI · Neonatal-Perinatal Medicine Physician in Wisconsin