DR. SHAWN MICHAEL SANICOLA DPM
NPI 1457356305
Podiatrist in Pewaukee, WI

Active since June 16, 2005PECOS EnrolledAccepts Medicare Assignment
2835 N GRANDVIEW BLVD STE 300, PEWAUKEE, WI 53072(262) 542-3779(262) 542-4428 Get Directions Write a Review

NPPES record last updated: February 16, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 16, 2022, Oct 7, 2019 (2 updates tracked since 2019).

About Dr. Shawn Michael Sanicola Dpm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHAWN MICHAEL SANICOLA DPM (NPI 1457356305) is an individual podiatrist in Pewaukee, Wisconsin, licensed in Wisconsin (883025) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Waukesha Memorial Hospital, and is a graduate of Kent State University College Of Podiatric Medicine (2002).

NPPES Registry Identity

NPI1457356305
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameDR. SHAWN MICHAEL SANICOLACredential: DPM
Location Address2835 N GRANDVIEW BLVD STE 300Pewaukee, WI 53072-5591
Mailing Address2835 N Grandview Blvd, Ste 300Pewaukee, WI 53072-5591 · (262) 542-3779 · Fax (262) 542-4428
Fax(262) 542-4428
Sole ProprietorNo
Medical School CMSKent State University College Of Podiatric MedicineGraduated 2002
Enumeration DateJune 16, 2005
Last NPPES UpdateFebruary 16, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 16, 2022
NPI 1457356305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License Licensed in WI · 883025
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
Also ListedPodiatrist · Sports MedicineTaxonomy 213ES0000X · License 883025 (WI)
Also ListedPodiatrist · Foot & Ankle SurgeryTaxonomy 213ES0103X · License 883025 (WI)
2835 N GRANDVIEW BLVD STE 300, Pewaukee, WI 53072

Other Identifiers 2

Other1457356305WI · Individual Npi
Other1316994924WI · Npi Group

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Shawn Michael Sanicola Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991722050
PECOS Enrollment IDI20051027000840
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of fingernails or toenails, 6 or more nails 11721
This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
695 services221 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
235 services176 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
134 services47 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
88 services70 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
85 services85 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
52 services38 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Waukesha Memorial Hospital

Acute Care Hospitals · Waukesha, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520008
Location725 American AveWaukesha, WI 53188 · Waukesha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53072 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500
DME-Orthotic Devices · category DF000N
1 supplier42 claims62 services$54.50 avg. paid by Medicare
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each A5513
DME-Orthotic Devices · category DF000N
1 supplier42 claims180 services$35.51 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Podiatrist (Foot & Ankle Surgery)
2835 N GRANDVIEW BLVD STE 300
PEWAUKEE, WI 53072
Podiatrist (Foot & Ankle Surgery)
2835 N GRANDVIEW BLVD STE 300
PEWAUKEE, WI 53072
Podiatrist (Foot & Ankle Surgery)
2835 N GRANDVIEW BLVD STE 300
PEWAUKEE, WI 53072
Podiatrist
2835 N GRANDVIEW BLVD STE 300
PEWAUKEE, WI 53072
Podiatrist (Foot & Ankle Surgery)
2835 N GRANDVIEW BLVD STE 300
PEWAUKEE, WI 53072

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shawn Sanicola's NPI number?

The NPI number for Shawn Sanicola is 1457356305. It was assigned to this individual provider in the NPPES registry on June 16, 2005.

Where is Shawn Sanicola located?

Shawn Sanicola practices at 2835 N Grandview Blvd Ste 300, Pewaukee, WI 53072. The listed phone number is (262) 542-3779.

What is Shawn Sanicola's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Shawn Sanicola enrolled in Medicare?

Yes. Shawn Sanicola is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shawn Sanicola accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and UnitedHealthcare list Shawn Sanicola as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shawn Sanicola affiliated with any hospitals?

According to CMS data, Shawn Sanicola is affiliated with Waukesha Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Shawn Sanicola was last updated on February 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.