SARA R. AVERY, PA-C — NPI 1124400791 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers

CMS-1500 Box 24J / 33a • NPI

1124400791

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

363A00000X (CMS 97)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant

Box 32 Service Location & ZIP+4

999 N 92ND ST STE 320, MILWAUKEE, WI, 53226-4875

✓ 9-Digit EDI 837 ZIP+4 (53226-4875)

Practice Phone & Referral Fax

(414) 266-6550

Fax: (414) 266-6579

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1124400791 (SARA R. AVERY, PA-C) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1124400791` (NPI-1 Individual Practitioner)
Provider / Legal Name	SARA R. AVERY, PA-C
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant NUCC Code: `363A00000X` (Physician Assistant)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	999 N 92ND ST STE 320, MILWAUKEE, WI, 53226-4875
Practice Telephone / Fax	Tel: (414) 266-6550 \| Fax: (414) 266-6579
Administrative Mailing Address	999 N 92ND ST STE 320, MILWAUKEE, WI, 53226-4875
Enumeration & Last Sync	Enumerated: 2015-06-19 \| CMS Record Updated: 2018-11-29

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

999 N 92ND ST STE 320, MILWAUKEE, WI, 53226-4875

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Plain-English Taxonomy & CMS Crosswalk (363A00000X)

What Does Taxonomy Code 363A00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 97 (Physician Assistant)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Physician Assistant for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (SARA R. AVERY, PA-C)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`363A00000X` — Physician Assistant Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant	State: WI \| License: `3623-23` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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SARA R. AVERY, PA-C (NPI #1124400791)