Sara J Anderson-Kim, APNP
Individual provider Active NPI Nurse Practitioner · Madison, WI
NPI 1902057052 · NPPES record last updated Oct 20, 2023
Key facts
- NPI
- 1902057052
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 9754 (WI)
- Practice address
- 752 N High Point Rd
Madison, WI 53717-2236 - Phone
- (608) 824-4000
- Fax
- (608) 824-4956
- NPI assigned
- Oct 7, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dean Health Systems Inc
Practice addresses (Care Compare)
752 N High Point Rd
Madison, WI 53717-2236
Phone (608) 824-4000
Hospital & facility affiliations
- SSM Health St Mary'S Hospital - Madison
- Loyola University Medical Center
- Sauk Prairie Hospital
- University of Wi Hospitals & Clinics Authority
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210721002263 | WI | Practitioner - Nurse Practitioner | 7810126067 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.007242 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dean Health Systems, Inc. | Current |
Accepting new patients | |
| Dean Health Systems, Inc | Current |
Accepting new patients |
Locations
752 N High Point Rd
Madison, WI 53717
Phone (608) 824-4000
1821 S Stoughton Rd
Madison, WI 53716
Phone (608) 260-6000
1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
Interoperability endpoints
- sandersonkim383997@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.007242 | IL | |
| Nurse Practitioner | 363L00000X | 9754 | WI | Yes |
Addresses
Primary practice location
752 N High Point Rd
Madison, WI 53717-2236
Mailing address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000
Other practice location 1
1821 S Stoughton Rd
Madison, WI 53716-2257
Phone (608) 260-6000
Other practice location 2
2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-9000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902057052 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sandersonkim383997@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other | |
| Direct Messaging Address | sandersonkim383997@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Other providers in Madison, WI
- Patrick C Andersen
- William Andersen
- Anderson & Shapiro Eye Surgeons, SC
- India Anise Anderson-Carter
- Heleen M. Anderson-Grant
- Nicole Anderson-Weiss
- Abigail Anderson
- Aleisha M Anderson
- Amy Elizabeth Anderson
- Ann Gile Anderson
All providers in Madison, WI · Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.