Active NPI
David J Kratzer, OT
- Occupational Therapist
- Milwaukee, WI
National Provider Identifier
1033119102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4191-26
- Practice address
- 316 N Milwaukee St
208
Milwaukee, WI 53202-5885 - Phone
- (414) 615-0665
- Fax
- (414) 615-0667
- NPI assigned
- Jul 29, 2005
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4191-26 | WI | Primary |
Addresses
Primary practice location
316 N Milwaukee St
208
Milwaukee, WI 53202-5885
Mailing address
1185 Sandpiper Dr
Oconomowoc, WI 53066-2363
Phone (262) 354-0515
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41063100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4191-26 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespeed Physical Therapy and Fitness | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Sussex, WI
- NPI 1366535742
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445212800000",
"number": "1033119102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1185 SANDPIPER DR",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530662363",
"telephone_number": "262-354-0515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 N MILWAUKEE ST",
"address_2": "208",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532025885",
"telephone_number": "414-615-0665",
"fax_number": "414-615-0667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRATZER",
"first_name": "DAVID",
"middle_name": "J",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-29",
"last_updated": "2015-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "4191-26",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41063100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.