Individual provider Active NPI

Manuel Alejandro Sanchez, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Kenosha, WI
National Provider Identifier
1750638441
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3005 Issued in WI
Practice address
10400 75TH St
Kenosha, WI 53142-7884
Phone
(262) 948-5600
NPI assigned
Aug 13, 2012
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3005-23 WI
Physician Assistant 363A00000X 3005 WI Primary

Addresses

Primary practice location

10400 75TH St
Kenosha, WI 53142-7884

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (262) 948-5600

Other practice location 1

111 E Wisconsin Ave
Suite 2100
Milwaukee, WI 53202-4815
Phone (414) 290-6700

Other identifiers 1

IdentifierTypeStateIssuer
100025081MedicaidWI

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address msanchez347623@direct.froedtert.com Direct
Direct Messaging Address msanchez375528@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121008000349 WI Practitioner - Physician Assistant 2668621657 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Swea Fort SCGroup PAC ID 0345774972, 51 clinicians
Vituity-Wisconsin HM SCGroup PAC ID 4880056126, 29 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2621 S Green Bay Rd
Racine, WI 53406-4948
Phone (262) 504-6100

611 Sherman Ave E
Fort Atkinson, WI 53538-1960
Phone (920) 568-5475

8400 Washington Ave
Mount Pleasant, WI 53406-3735
Phone (262) 321-3000

9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3005WIMDPhysician Assistant
3005-23WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Swea Fort SC CurrentSince Sep 7, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 1, 2023 Accepting new patients
DRS. Massaro & Kalenak S C Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Vituity-Wisconsin Em SC CurrentSince Aug 15, 2023 Accepting new patients
Vituity-Wisconsin Em SC CurrentSince Aug 15, 2023 Accepting new patients
Ihc-Libertyville Emergency Physicians, LLC Physician Assistant Past Accepting new patients
Edgerton Hospital and Health Services Past Accepting new patients
Edgerton Hospital and Health Services, Inc Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

111 E Wisconsin Ave
Ste 2100
Milwaukee, WI 53202
Phone (414) 290-6700

2301 N Lake Dr
Milwaukee, WI 53211
Phone (414) 270-4932

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

3237 S 16th St
Milwaukee, WI 53215
Phone (414) 647-5000

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Interoperability endpoints

  • Direct secure messaging: msanchez347623@direct.froedtert.com
  • Direct secure messaging: msanchez375528@direct.myadvocateaurora.org

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1750638441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "262-948-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E Wisconsin Ave",
            "address_2": "Suite 2100",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532024815",
            "country_code": "US",
            "telephone_number": "414-290-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "MANUEL",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-13",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "3005-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100025081",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msanchez347623@direct.froedtert.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "111 E Wisconsin Ave",
            "address_2": "Suite 2100",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532024815",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msanchez375528@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531427884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531427884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.