Mary Ellen Ewanowski, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2005-024 Issued in WI

Practice address

2501 W Beltline Hwy Ste 601
Madison, WI 53713-2309

Phone

(608) 260-6004

Fax

(608) 288-6496

NPI assigned

Jan 29, 2008

Last updated

Nov 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mewanowski262828@direct-ehr-ssmhc.com

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1043497324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W BELTLINE HWY STE 601",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132309",
            "telephone_number": "608-260-6004",
            "fax_number": "608-288-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W BELTLINE HWY STE 601",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132309",
            "telephone_number": "608-260-6004",
            "fax_number": "608-288-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWANOWSKI",
        "first_name": "MARY ELLEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2005-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043497324",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mewanowski262828@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mewanowski262828@direct-ehr-ssmhc.com",
            "address_1": "2501 W Beltline Hwy Ste 601",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537132309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2501 W Beltline Hwy Ste 601",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537132309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Madison, WI
• Providers in Madison, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.