Individual provider Active NPI

Kiley Elizabeth Sabin

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1487395307
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7542 Issued in WI
Practice address
2801 W KK River Pkwy Ste 370
Milwaukee, WI 53215-3678
Phone
(414) 649-7900
Fax
(414) 649-7499
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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 7542 WI Primary

Addresses

Primary practice location

2801 W KK River Pkwy Ste 370
Milwaukee, WI 53215-3678

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

3200 Grand Ave
Des Moines, IA 50312-4104
Phone (515) 271-1569

Other identifiers 1

IdentifierTypeStateIssuer
100251348MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ksabin382667@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230929000337 WI Practitioner - Physician Assistant 8325492036 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

200 E Ryan Rd
Oak Creek, WI 53154-4563
Phone (414) 570-3590

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

2424 S 90TH St
Suite 306
West Allis, WI 53227-2455
Phone (414) 328-8750

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6000

2999 N Mayfair Rd
Suite 100
Wauwatosa, WI 53222-4306
Phone (414) 479-7000

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5950

9000 W Sura LN
Greenfield, WI 53228-3477
Phone (414) 246-6800

9120 W Loomis Rd
Suite 100
Franklin, WI 53132-9083
Phone (414) 858-1740

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-2000

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Sep 23, 2023 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Sep 23, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 23, 2023 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Sep 23, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 23, 2023 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

975 Port Washington Rd
Ste 110
Grafton, WI 53024
Phone (262) 329-1000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2801 W Kinnickinnic River Pkwy
Ste 370
Milwaukee, WI 53215
Phone (414) 649-1280

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

945 N 12th St
Ste 1200
Milwaukee, WI 53233
Phone (414) 219-3300

9000 W Sura Ln
Milwaukee, WI 53228
Phone (414) 246-6500

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

S68W15500 Janesville Rd
Muskego, WI 53150
Phone (414) 422-2180

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2900

200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

2999 N Mayfair Rd
Wauwatosa, WI 53222
Phone (414) 479-3737

2424 S 90th St
Ste 500
West Allis, WI 53227
Phone (414) 321-2255

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1487395307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KK RIVER PKWY STE 370",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153678",
            "telephone_number": "414-649-7900",
            "fax_number": "414-649-7499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503124104",
            "country_code": "US",
            "telephone_number": "515-271-1569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SABIN",
        "first_name": "KILEY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2023-12-20",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251348",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksabin382667@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kk River Pkwy Ste 370",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kk River Pkwy Ste 370",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.