Individual provider Active NPI

Maria T Joseph, PT, DPT

  • Physical Therapist
  • Neenah, WI
National Provider Identifier
1033595087
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13063-24 Issued in WI
Practice address
1305 W American Dr
Neenah, WI 54956-1993
Phone
(920) 725-9373
NPI assigned
Jul 31, 2015
Last updated
Dec 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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 13063-24 WI Primary

Addresses

Primary practice location

1305 W American Dr
Neenah, WI 54956-1993

Mailing address

1639 Swan Rd
Apt 3
De Pere, WI 54115-4030
Phone (920) 418-1835

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150807013243 WI Practitioner - Physical Therapist in Private Practice 9234443029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Missouri St Louis - School of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Neuroscience Group of Northeast Wisconsin SCGroup PAC ID 6204740186, 57 clinicians

Practice addresses (Care Compare)

1305 W American Dr
Neenah, WI 54956-1993
Phone (800) 201-1194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13063-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Neuroscience Group of Northeast Wisconsin SC Physical Therapist CurrentSince Nov 19, 2016 Accepting new patients

Locations

445 W Calumet St
Appleton, WI 54915

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

1305 West American Dr
Neenah, WI 54956
Phone (920) 729-7687

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, 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": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1033595087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 SWAN RD",
            "address_2": "APT 3",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541154030",
            "telephone_number": "920-418-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W AMERICAN DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561993",
            "telephone_number": "920-725-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "MARIA",
        "middle_name": "T",
        "name_prefix": "Miss",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13063-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.