Individual provider Active NPI

Carol Dusold, P.T.

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1033195706
Registry record updated Mar 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4588 Issued in WI
Practice address
3073 S Chase Ave Ste 630
Milwaukee, WI 53207-2668
Phone
(414) 292-3275
Fax
(414) 292-3298
NPI assigned
Dec 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4588 WI Primary

Addresses

Primary practice location

3073 S Chase Ave Ste 630
Milwaukee, WI 53207-2668

Mailing address

3073 S Chase Ave Ste 630
Milwaukee, WI 53207-2668
Phone (414) 292-3275

Other identifiers 1

IdentifierTypeStateIssuer
40219900MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070731000494 WI Practitioner - Physical Therapist in Private Practice 5294836581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Plus Management CorpGroup PAC ID 9830255918, 14 clinicians

Practice addresses (Care Compare)

3073 S Chase Ave BLDG 28
Suite 630
Milwaukee, WI 53207-2638
Phone (414) 292-3275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4588WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
PT Plus Management Corp Physical Therapist CurrentSince Dec 24, 2016 Accepting new patients
Chad Novasic PT LTD Physical Therapist Past Accepting new patients
Whole Path Psychotherapy LLC PastSince Dec 24, 2016 Accepting new patients

Locations

700 Pilgrim Pkwy
Ste L8
Elm Grove, WI 53122
Phone (262) 289-1950

5663 S 27th St
Milwaukee, WI 53221
Phone (414) 281-0251

2915 W Layton Ave
Milwaukee, WI 53221
Phone (262) 796-2850

3073 S Chase Ave
Ste 630
Milwaukee, WI 53207
Phone (414) 292-3275

241 N Broadway
Ste 403
Milwaukee, WI 53202
Phone (262) 796-2850

1532 S Green Bay Rd
Ste 200
Mount Pleasant, WI 53406
Phone (262) 631-0474

Organizations & group practices 3

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520208000000",
    "number": "1033195706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3073 S CHASE AVE STE 630",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532072668",
            "telephone_number": "414-292-3275",
            "fax_number": "414-292-3298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 S CHASE AVE STE 630",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532072668",
            "telephone_number": "414-292-3275",
            "fax_number": "414-292-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSOLD",
        "first_name": "CAROL",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2018-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40219900",
            "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 Mar 5, 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.

Verify at the official NPI Registry.