Samuel Wenzlaff, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14685 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

Feb 22, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115
  Medicare reassignment NPD
• Gundersen Lutheran Express Care, Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1043446974
  NPD

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1043777329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZLAFF",
        "first_name": "SAMUEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-22",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1315497",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill K Wenthe, RD
• Amy Wentland, M.D.
• Frederick Wentland
• Heidi Wentland
• Luke Richard Wenzel, D.O.
• Albert Mark Werner, D.D.S
• Madison Werner, AA
• Blaine T Wertz
• Aubrey Wesely, PA
• Rachel Weslo

• Physical Therapist in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.