Active NPI
Jill San Agustin, C.A., MSOM, BS
- Acupuncturist
- Pewaukee, WI
National Provider Identifier
1942402607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 501-055
- Practice address
- 2900 Golf Road
Pewaukee, WI 53072 - Phone
- (262) 513-7237
- NPI assigned
- Jun 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 501-055 | WI | Primary |
Addresses
Primary practice location
2900 Golf Road
Pewaukee, WI 53072
Mailing address
2211 S Robinson Ave
Milwaukee, WI 53207-1337
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 501-055 | WI | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204761600000",
"number": "1942402607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2211 S ROBINSON AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532071337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 GOLF ROAD",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "53072",
"telephone_number": "262-513-7237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAN AGUSTIN",
"first_name": "JILL",
"credential": "C.A., MSOM, BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-04",
"last_updated": "2008-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "WI",
"license": "501-055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pewaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.