Active NPI
Melissa M Mikuski, RPT
- Geriatric Physical Therapist
- Madison, WI
National Provider Identifier
1093214371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 12206-24
- Practice address
- 718 Jupiter Dr
Madison, WI 53718-2950 - Phone
- (608) 663-8600
- NPI assigned
- Feb 1, 2018
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 12206-24 | WI | Primary |
Addresses
Primary practice location
718 Jupiter Dr
Madison, WI 53718-2950
Mailing address
4219 Owl Creek Dr
Madison, WI 53718-4409
Phone (860) 459-9991
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12206-24 | Other | WI | PHYSICAL THERAPIST |
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 |
|---|---|---|---|
| 12206-24 | WI | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517443200000",
"number": "1093214371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4219 OWL CREEK DR",
"city": "MADISON",
"state": "WI",
"postal_code": "537184409",
"telephone_number": "860-459-9991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "718 JUPITER DR",
"city": "MADISON",
"state": "WI",
"postal_code": "537182950",
"telephone_number": "608-663-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKUSKI",
"first_name": "MELISSA",
"middle_name": "M",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-01",
"last_updated": "2018-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "WI",
"license": "12206-24",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPIST",
"identifier": "12206-24",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.