Individual provider Active NPI

Sara Pfender

  • Pediatric Nurse Practitioner
  • Madison, WI
National Provider Identifier
1700256054
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
11453 Issued in WI
Practice address
418 N Baldwin St
Madison, WI 53703-1745
Phone
(650) 438-1445
NPI assigned
Sep 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 11453 WI Primary

Addresses

Primary practice location

418 N Baldwin St
Madison, WI 53703-1745

Mailing address

418 N Baldwin St
Madison, WI 53703-1745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11453WIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Aug 1, 2018 Accepting new patients
Salud Para la Gente CurrentSince Sep 8, 2015 Accepting new patients
County of San Mateo CurrentSince Aug 1, 2018 Accepting new patients
Salud Para la Gente Current Accepting new patients
County of San Mateo CurrentSince Aug 1, 2018 Accepting new patients
Salud Para la Gente CurrentSince Sep 8, 2015 Accepting new patients

Locations

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

195 Aviation Way
Ste 200
Watsonville, CA 95076

204 E Beach St
Watsonville, CA 95076
Phone (831) 763-3413

45 Nielson St
Watsonville, CA 95076
Phone (831) 761-1588

Organizations & group practices 6

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": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1700256054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 N BALDWIN ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537031745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 N BALDWIN ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537031745",
            "telephone_number": "650-438-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFENDER",
        "first_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "11453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.