Active NPI
Susan Schober Kinosian, P.T.
- Physical Therapist
- New Berlin, WI
National Provider Identifier
1063549475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1235--024
- Practice address
- 2895 S Moorland Rd
New Berlin, WI 53151-3743 - Phone
- (262) 782-9015
- Fax
- (262) 782-9013
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1235--024 | WI | Primary |
Addresses
Primary practice location
2895 S Moorland Rd
New Berlin, WI 53151-3743
Mailing address
1815 N 72ND St
Wauwatosa, WI 53213-2353
Phone (414) 258-4525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1235--024 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Curative New Berlin Therapies, LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
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- Milwaukee, WI
- NPI 1730216144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063549475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 N 72ND ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532132353",
"telephone_number": "414-258-4525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2895 S MOORLAND RD",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531513743",
"telephone_number": "262-782-9015",
"fax_number": "262-782-9013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINOSIAN",
"first_name": "SUSAN",
"middle_name": "SCHOBER",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "1235--024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.