Individual provider Active NPI

Sarah P. Hansen, MD

  • Pediatric Adolescent Medicine Physician
  • Waukesha, WI
National Provider Identifier
1619918992
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
47397-020 Issued in WI
Practice address
1111 Delafield Street
Suite 115
Waukesha, WI 53188
Phone
(262) 542-2536
Fax
(262) 542-2791
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 47397-020 WI Primary

Addresses

Primary practice location

1111 Delafield Street
Suite 115
Waukesha, WI 53188

Mailing address

1111 Delafield Street
Suite 115
Waukesha, WI 53188
Phone (262) 542-2536

Other identifiers 1

IdentifierTypeStateIssuer
34841400MedicaidWI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47397-020WIMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waukesha Pediatric Associates Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shansen20671@direct.phci.org

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254096000000",
    "number": "1619918992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD STREET",
            "address_2": "SUITE 115",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-542-2536",
            "fax_number": "262-542-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD STREET",
            "address_2": "SUITE 115",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-542-2536",
            "fax_number": "262-542-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "SARAH",
        "middle_name": "P.",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2009-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WI",
            "license": "47397-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34841400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.