Jacqueline Sandoval, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11827-24 Issued in WI

Practice address

3305 S 20TH St Ste 100
Milwaukee, WI 53215-4940

Phone

(414) 645-1984

Fax

(414) 389-9050

NPI assigned

Jan 30, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsandoval196698@direct.myadvocateaurora.org

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.

• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • Saint Francis, WI
  • NPI 1003861188

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Aurora Health Care Metro, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1861447179
  NPD (past)
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD (past)

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1497292379",
    "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": "3305 S 20TH ST STE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154940",
            "telephone_number": "414-645-1984",
            "fax_number": "414-389-9050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2615 N Downer Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532114245",
            "country_code": "US",
            "telephone_number": "414-962-4400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "544 E Ogden Ave",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532022698",
            "country_code": "US",
            "telephone_number": "414-224-7834",
            "fax_number": "414-224-7835",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "544 E Ogden Ave",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532022698",
            "country_code": "US",
            "telephone_number": "414-224-7834",
            "fax_number": "414-224-7835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "JACQUELINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11827-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100064190",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsandoval196698@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "544 E Ogden Ave",
            "address_2": "Ste 200",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532022698",
            "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": "544 E Ogden Ave",
            "address_2": "Ste 200",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532022698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jay I Sandlow, MD
• David S. Sandock, MD
• Andrea Karen Sandora, LCSW
• Alisebeth Sandoval, CCC-SLP
• Hilda Sandoval, CSAC
• Cheryl A Sandrin, PA-C
• Ann F Sandstrom, RN
• Paul Mark Sandvick, D.D.S.
• Jacqueline Kaye Sandwidi, DO
• Samantha A Sanfelippo, PT

• Physical Therapist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.