Individual provider Active NPI

Sara Ellefson, AUD

  • Audiologist
  • Mequon, WI
National Provider Identifier
1649043688
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1047-156 Issued in WI
Practice address
11649 N Port Washington Rd Ste 105
Mequon, WI 53092-3459
Phone
(262) 241-3144
Fax
(262) 241-3186
NPI assigned
Nov 1, 2023
Last updated
May 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1047-156 WI Primary

Addresses

Primary practice location

11649 N Port Washington Rd Ste 105
Mequon, WI 53092-3459

Mailing address

11649 N Port Washington Rd Ste 105
Mequon, WI 53092-3459
Phone (262) 241-3144

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231120000826 WI Practitioner - Qualified Audiologist 0749638401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Northwestern University Feinberg Medical School, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11649 N Port Washington Rd
Suite 105
Mequon, WI 53092-3459
Phone (262) 241-3144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1047-156WIMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Hearing Solutions of Wisconsin SC Audiologist CurrentSince Oct 31, 2023 Accepting new patients
Audiology Hearing Clinic of Mequon, S.C. Audiologist CurrentSince Oct 31, 2023 Accepting new patients
Audiololgy Hearing Clinic of Mequon LLC Past Accepting new patients

Locations

12780 W North Ave
Ste B
Brookfield, WI 53005
Phone (262) 784-9300

11649 N Port Washington Rd
Ste 105
Mequon, WI 53092
Phone (262) 241-3144

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1649043688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11649 N PORT WASHINGTON RD STE 105",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923459",
            "telephone_number": "262-241-3144",
            "fax_number": "262-241-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11649 N PORT WASHINGTON RD STE 105",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923459",
            "telephone_number": "262-241-3144",
            "fax_number": "262-241-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEFSON",
        "first_name": "SARA",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-01",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "1047-156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.