Individual provider Active NPI

Alyssa Rose Henke, PT, DPT

  • Geriatric Physical Therapist
  • Greendale, WI
National Provider Identifier
1013654508
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
Practice address
7711 Freeland CT
Greendale, WI 53129-1658
Phone
(414) 210-0088
Fax
(414) 509-1630
NPI assigned
May 16, 2022
Last updated
May 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X NU Primary

Addresses

Primary practice location

7711 Freeland CT
Greendale, WI 53129-1658

Mailing address

PO Box 620
Greendale, WI 53129-0620
Phone (414) 344-8245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220713002052 WI Practitioner - Physical Therapist in Private Practice 6608257381 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Paxxon Healthcare Services LLCGroup PAC ID 8325959554, 153 clinicians

Practice addresses (Care Compare)

1111 E Capitol Dr
Shorewood, WI 53211-1810
Phone (414) 312-8146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paxxon Healthcare Services LLC CurrentSince Jan 5, 2024 Accepting new patients
Therapy at Home, Home Health Agency Inc CurrentSince Dec 15, 2024 Accepting new patients
Comprehensive Podiatry Services CurrentSince Oct 1, 2023 Accepting new patients
Paxxon Healthcare Services LLC CurrentSince Jan 5, 2024 Accepting new patients
Therapy at Home LLC Geriatrics CurrentSince Jun 6, 2022 Accepting new patients
Muslim Community and Health Center of Wisconsin Inc CurrentSince Oct 1, 2023 Accepting new patients

Locations

307 W Layton Ave
Unit 2B
Milwaukee, WI 53207

803 W Layton Ave
Milwaukee, WI 53221
Phone (414) 253-8330

1111 E Capitol Dr
Shorewood, WI 53211
Phone (262) 293-3207

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1013654508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 620",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531290620",
            "telephone_number": "414-344-8245",
            "fax_number": "414-509-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7711 FREELAND CT",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531291658",
            "telephone_number": "414-210-0088",
            "fax_number": "414-509-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKE",
        "first_name": "ALYSSA",
        "middle_name": "ROSE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.