Individual provider Active NPI

Samantha Marie Morache, DPT

  • Physical Therapist
  • Wausau, WI
National Provider Identifier
1053176347
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16212-24 Issued in WI
Practice address
333 Pine Ridge Blvd
Wausau, WI 54401-4102
Phone
(800) 283-2881
NPI assigned
Feb 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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 16212-24 WI Primary

Addresses

Primary practice location

333 Pine Ridge Blvd
Wausau, WI 54401-4102

Mailing address

1401 Elm St Apt 306
Wausau, WI 54401-4736
Phone (715) 302-5984

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240508000979 WI Practitioner - Physical Therapist in Private Practice 4183065170 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phyt Rehab of Wisconsin IncGroup PAC ID 5395122196, 6 clinicians

Practice addresses (Care Compare)

911 Jackson St
Suite 101
Wausau, WI 54403-1300
Phone (914) 837-6538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16212-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital, Inc. CurrentSince Jul 16, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jul 16, 2024 Accepting new patients
Phyt Rehab of Wisconsin, Inc. Physical Therapist CurrentSince Apr 1, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

171 Kings Hwy
Brooklyn, NY 11223
Phone (877) 722-7700

911 Jackson St
Ste 101
Wausau, WI 54403
Phone (914) 837-6538

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

Organizations & group practices 4

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": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1053176347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 ELM ST APT 306",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014736",
            "telephone_number": "715-302-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014102",
            "telephone_number": "800-283-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORACHE",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16212-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.