Active NPI
Tyler Raymaker, DPT, PT
- Physical Therapist
- Kenosha, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13966-24
- Practice address
- 3701 80TH St
Kenosha, WI 53142-4950 - Phone
- (262) 697-1730
- NPI assigned
- Nov 6, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 13966-24 | WI | Primary |
Addresses
Primary practice location
3701 80TH St
Kenosha, WI 53142-4950
Mailing address
625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-1980
Other practice location 1
8333 Gridley Ave
Wauwatosa, WI 53213-3041
Phone (920) 639-3291
Other practice location 2
8333 Gridley Ave
Wauwatosa, WI 53213-3041
Phone (920) 639-3291
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2615 N Downer Ave
Milwaukee, WI 53211-4245
Phone (414) 962-4400
4749 S 76TH St
Greenfield, WI 53220-4301
Phone (414) 281-1380
5708 B 75TH St
Kenosha, WI 53142-3635
Phone (262) 697-9135
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.32 of 100
- Quality
- 84.44
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 70.78
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
Locations
625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250
600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250
4749 S 76th St
Greenfield, WI 53220
Phone (414) 281-1380
3701 80th St
Kenosha, WI 53142
Phone (262) 697-1730
5708 75th St
#B
Kenosha, WI 53142
Phone (262) 697-9135
3535 30th Ave
Ste 101
Kenosha, WI 53144
Phone (262) 654-0260
2615 N Downer Ave
Milwaukee, WI 53211
Phone (414) 962-4400
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1023521663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 ENTERPRISE DR",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605238813",
"telephone_number": "630-575-1980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 80TH ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531424950",
"telephone_number": "262-697-1730"
}
],
"practiceLocations": [
{
"address_1": "8333 Gridley Ave",
"address_purpose": "LOCATION",
"city": "Wauwatosa",
"state": "WI",
"postal_code": "532133041",
"country_code": "US",
"telephone_number": "920-639-3291",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8333 Gridley Ave",
"address_purpose": "LOCATION",
"city": "Wauwatosa",
"state": "WI",
"postal_code": "532133041",
"country_code": "US",
"telephone_number": "920-639-3291",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAYMAKER",
"first_name": "TYLER",
"credential": "DPT, PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-06",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "13966-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.