Individual provider Active NPI

Sabrina Marie Azavedo, MD

  • Family Medicine Physician
  • Elkhorn, WI
National Provider Identifier
1780201145
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10029-851 Issued in WI
Practice address
W3985 County Road NN
Elkhorn, WI 53121-4337
Phone
(262) 741-2121
NPI assigned
Jul 1, 2020
Last updated
Jun 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X T-4138 MS
Emergency Medicine Physician 207P00000X T-4138 MS
Student in an Organized Health Care Education/Training Program 390200000X WI
General Practice Physician 208D00000X 0101274241 VA
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 10029-851 WI Primary

Addresses

Primary practice location

W3985 County Road NN
Elkhorn, WI 53121-4337

Mailing address

1009 W Juneau Ave Apt 309
Milwaukee, WI 53233-1517
Phone (757) 957-2060

Other practice location 1

611 Alcorn Dr
Corinth, MS 38834-9388
Phone (757) 957-2060

Other practice location 2

8101 Hinson Farm Rd Ste 219
Alexandria, VA 22306-3406
Phone (214) 725-2211

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
I20250115000886 WI Order and Referring Only - Family PracticePractitioner - Family Practice 5698152304

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3301 W Forest Home Ave
Milwaukee, WI 53215-2843

N20W22961 Watertown Rd
Waukesha, WI 53186-1308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10029-851WIMDFamily Medicine Physician
T-4138MSMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1780201145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 W JUNEAU AVE APT 309",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331517",
            "telephone_number": "757-957-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3985 COUNTY ROAD NN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214337",
            "telephone_number": "262-741-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 Alcorn Dr",
            "address_purpose": "LOCATION",
            "city": "Corinth",
            "state": "MS",
            "postal_code": "388349388",
            "country_code": "US",
            "telephone_number": "757-957-2060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8101 Hinson Farm Rd Ste 219",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223063406",
            "country_code": "US",
            "telephone_number": "214-725-2211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZAVEDO",
        "first_name": "SABRINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MS",
            "license": "T-4138",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "T-4138",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101274241",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "10029-851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, WI

Sources for this page

Verify at the official NPI Registry.