Active NPI
Adam Joseph Sangermano, ABOC
- Optician
- Pewaukee, WI
National Provider Identifier
1619669942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 236760
- Practice address
- 411 Pewaukee Rd
Pewaukee, WI 53072-5886 - Phone
- (262) 695-3191
- Fax
- (262) 695-3806
- NPI assigned
- May 24, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 236760 | WI | Primary |
Addresses
Primary practice location
411 Pewaukee Rd
Pewaukee, WI 53072-5886
Mailing address
1625 E Sunset Dr Apt 108
Waukesha, WI 53189-8215
Phone (262) 399-1998
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 236760 | WI | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684886400000",
"number": "1619669942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1625 E SUNSET DR APT 108",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531898215",
"telephone_number": "262-399-1998",
"fax_number": "262-695-3806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 PEWAUKEE RD",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530725886",
"telephone_number": "262-695-3191",
"fax_number": "262-695-3806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANGERMANO",
"first_name": "ADAM",
"middle_name": "JOSEPH",
"credential": "ABOC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-24",
"last_updated": "2023-05-24",
"certification_date": "2023-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "WI",
"license": "236760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pewaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.