Individual provider Active NPI

Vincent Paul Savaglio, MD

  • Ophthalmology Physician
  • Kenosha, WI
National Provider Identifier
1639247828
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
16444020 Issued in WI
Practice address
3535 30TH Avenue
Suite 102
Kenosha, WI 53144
Phone
(262) 657-3636
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 16444020 WI Primary

Addresses

Primary practice location

3535 30TH Avenue
Suite 102
Kenosha, WI 53144

Mailing address

3535 30TH Avenue
Suite 102
Kenosha, WI 53144
Phone (262) 657-3636

Other identifiers 1

IdentifierTypeStateIssuer
31101700MedicaidWI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071110000015 WI Practitioner - Ophthalmology 8224126149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16444020WIMDOphthalmology Physician
16444WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Savaglio Eye Clinic SC Ophthalmology CurrentSince Jan 1, 1966 Accepting new patients

Locations

3535 30th Ave
Ste 102
Kenosha, WI 53144
Phone (262) 657-3636

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639247828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 30TH AVENUE",
            "address_2": "SUITE 102",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53144",
            "telephone_number": "262-657-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 30TH AVENUE",
            "address_2": "SUITE 102",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53144",
            "telephone_number": "262-657-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAVAGLIO",
        "first_name": "VINCENT",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "16444020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31101700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.