Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Sara I Vanderburgh, PA-C

Individual provider Physician Assistant · NPI 1104334713

Mrs. Sara I Vanderburgh, PA-C is a Physician Assistant in Greenfield, Wisconsin. Qualified in 2017, 9 years ago. Practices with Lakeshore Medical Clinic LLC, a 379-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
9
Licensed in
WI
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6901 W Edgerton Ave
Greenfield, WI 53220-4420
Phone: (414) 325-5244
Fax: (414) 421-3772
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4231 (WI)

Record details

NPI number1104334713
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJanuary 17, 2018
Last updated in NPPESFebruary 27, 2024
Certification dateFebruary 27, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Lakeshore Medical Clinic Llc — 379 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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