Individual provider Active NPI

Thomas Connor Felstead, PT, DPT

  • Physical Therapist
  • Janesville, WI
National Provider Identifier
1093454092
Registry record updated Jul 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15788-24 Issued in WI
Practice address
1200 N Sumac Dr
Janesville, WI 53545-2183
Phone
(608) 284-8791
NPI assigned
May 31, 2022
Last updated
Jul 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2026

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 15788-24 WI Primary

Addresses

Primary practice location

1200 N Sumac Dr
Janesville, WI 53545-2183

Mailing address

1200 N Sumac Dr
Janesville, WI 53545-2183
Phone (608) 284-8791

Other identifiers 1

IdentifierTypeStateIssuer
1093454092MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220614001627 WI Practitioner - Physical Therapist in Private Practice 9234518788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1006 Blaine St
Edgerton, WI 53534-1206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15788-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Physical Therapy LLC Physical Therapist CurrentSince Sep 29, 2022 Accepting new patients
The Foundry Physical Therapy LLC Past Accepting new patients

Locations

102 W Fulton St
Edgerton, WI 53534
Phone (608) 290-5883

Interoperability endpoints

  • Direct secure messaging: tfelstead421480@direct-ehr-ssmhc.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783814400000",
    "number": "1093454092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N SUMAC DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535452183",
            "telephone_number": "608-284-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N SUMAC DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535452183",
            "telephone_number": "608-284-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELSTEAD",
        "first_name": "THOMAS",
        "middle_name": "CONNOR",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2026-07-12",
        "certification_date": "2026-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15788-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093454092",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2026; 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.