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MRS. SANDRA RENEE MOOG MS/CCC-SLP
NPI 1467625269
Speech-Language Pathologist in Milwaukee, WI

Active since April 12, 2008Accepts Medicare Assignment
3540 S 43RD ST, MILWAUKEE, WI 53220(414) 328-2104 Get Directions Write a Review

NPPES record last updated: April 12, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Sandra Renee Moog Ms/ccc-slp NPPES

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

MRS. SANDRA RENEE MOOG MS/CCC-SLP (NPI 1467625269) is an individual speech-language pathologist provider in Milwaukee, Wisconsin, licensed in Wisconsin (2681-154) and active in the NPI registry since April 2008. She is a graduate of Other (2004).

NPPES Registry Identity

NPI1467625269
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameMRS. SANDRA RENEE MOOGCredential: MS/CCC-SLP
Location Address3540 S 43RD STMilwaukee, WI 53220-1502
Mailing Address3456 S 35th StMilwaukee, WI 53215-4104 · (414) 333-4680
Phone(414) 328-2104
Sole ProprietorYes
Medical School CMSOtherGraduated 2004
Enumeration DateApril 12, 2008
✔ NPI 1467625269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in WI · 2681-154
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
3540 S 43RD ST, Milwaukee, WI 53220
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Other Identifiers 1

Medicaid42586400WI

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Sandra Renee Moog Ms/ccc-slp 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 ID840543674
PECOS Enrollment IDI20181025000178

Medicare Billing Reassignment

Medicare enrollment records show Sandra Moog reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Reliant Senior Living LLC
8.3 mi
Physical Therapist
1111 E CAPITOL DR
Shorewood, WI 53211
  • Reassigned Medicare billing, Wisconsin enrollment
  • 6 clinicians in this Medicare group
NPI 1013899582 (414) 204-1060

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

JOSEPH SPENCER
Skilled Nursing Facility
3540 S 43RD ST
MILWAUKEE, WI 53220
Milwaukee County (414) 541-1000
MRS. DARA J MICKSCHL PA-C
Physician Assistant
3540 S 43RD ST
MILWAUKEE, WI 53220
Milwaukee County (872) 231-3162
TAMMY PETERSON PTA
Physical Therapy Assistant
3540 S 43RD ST
MILWAUKEE, WI 53220
Milwaukee County (414) 328-2128
MRS. MARY FRANCES ALTIERI OTR
Occupational Therapist
3540 S 43RD ST
MILWAUKEE, WI 53220
Milwaukee County (414) 541-1000
PAULA BIASI TRUSKY PTA
Physical Therapy Assistant
3540 S 43RD ST
MILWAUKEE, WI 53220
Milwaukee County (414) 541-1000
JOEL KOLBERG
Skilled Nursing Facility
3540 S 43RD ST
MILWAUKEE, WI 53220
Milwaukee County (414) 541-1000
JORDAN CERVENKA
Occupational Therapist
3540 S 43RD ST
MILWAUKEE, WI 53220
Milwaukee County (414) 328-2128
MR. SHANE DAVID FRASHER COTA
Occupational Therapy Assistant
3540 S 43RD ST
MILWAUKEE, WI 53220
Milwaukee County (414) 328-2104

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 Sandra Moog's NPI number?

The NPI number for Sandra Moog is 1467625269. It was assigned to this individual provider in the NPPES registry on April 12, 2008.

Where is Sandra Moog located?

Sandra Moog practices at 3540 S 43rd St, Milwaukee, WI 53220. The listed phone number is (414) 328-2104.

What is Sandra Moog's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Sandra Moog enrolled in Medicare?

Yes. Sandra Moog 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.

Which organization bills Medicare for Sandra Moog's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sandra Moog reassigns Medicare benefits to Reliant Senior Living LLC (Shorewood, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sandra Moog's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sandra Moog was last updated on April 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.