Individual provider Active NPI

Tia Mathwich, PT

  • Physical Therapist
  • Beaver Dam, WI
National Provider Identifier
1043798341
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14176-24 Issued in WI
Practice address
707 S University Ave
Beaver Dam, WI 53916-3027
Phone
(920) 887-7181
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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 14176-24 WI Primary

Addresses

Primary practice location

707 S University Ave
Beaver Dam, WI 53916-3027

Mailing address

314 Hickory CT
Orfordville, WI 53576-9599
Phone (608) 295-1705

Other names 1

  • Tia Collins Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230126002455 WI Practitioner - Physical Therapist in Private Practice 6507237724 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14176WIMDPharmacist
14176-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Flambeau Hospital Inc CurrentSince Jan 12, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jan 12, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Jan 12, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince Jan 12, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jan 12, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Jan 12, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Jan 12, 2023 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jan 12, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince Jan 12, 2023 Accepting new patients

Locations

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

705 S University Ave
Ofc
Beaver Dam, WI 53916

707 S University Ave
Beaver Dam, WI 53916
Phone (920) 887-4006

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Fl 2
Marshfield, WI 54449

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 9

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1043798341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 HICKORY CT",
            "city": "ORFORDVILLE",
            "state": "WI",
            "postal_code": "535769599",
            "telephone_number": "608-295-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163027",
            "telephone_number": "920-887-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHWICH",
        "first_name": "TIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14176-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIA",
            "last_name": "COLLINS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.