Debra Joan Sanfilippo, PA
Individual provider Active NPI Physician Assistant · Minocqua, WI
NPI 1922035898 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1922035898
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 296023 (WI)
- Practice address
- 9900 Kawaga Rd
Minocqua, WI 54548-9107 - Phone
- (715) 356-8000
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 296023 | WI | MD | Physician Assistant |
| 296 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ABA Family Medicine, LLC | Past | Accepting new patients | |
| Sterthaus ER SVCS Partnership LLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/11761/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 296023 | WI | Yes |
Addresses
Primary practice location
9900 Kawaga Rd
Minocqua, WI 54548-9107
Mailing address
9900 Kawaga Rd
Minocqua, WI 54548-9107
Phone (715) 358-9730
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42939600 | Medicaid | WI |
Other providers in Minocqua, WI
- Theresa Riebe
- Leonna Christine Robertson
- Anna M Rosen
- Adam David Ross
- Doris L Ruder
- Michael J Schaars
- Suzanne L Scheldroup
- Sara Walker Scholten
- Alyssa J Schwanda
- Grace Schwantes
All providers in Minocqua, WI · Physician Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.