Katelyn Maydaniuk, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1508624 Issued in WI

Practice address

10930 W Potter Rd Ste C
Wauwatosa, WI 53226-3450

Phone

(414) 400-6556

Fax

(414) 400-6557

NPI assigned

Jul 16, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aretas01 LLCGroup PAC ID 0244699460, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Aretas01, LLC

  • Physical Therapist
  • Wauwatosa, WI
  • NPI 1801583224
  Medicare reassignment Care Compare group NPD
• Team Rehabilitation Services, LLC

  • Physical Therapist
  • Menomonee Falls, WI
  • NPI 1144990490
  Medicare reassignment NPD
• Team Rehabilitation Services, LLC

  • Physical Therapist
  • Marietta, GA
  • NPI 1508538158
  NPD

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1104434182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10930 W POTTER RD STE C",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263450",
            "telephone_number": "414-400-6556",
            "fax_number": "414-400-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10930 W POTTER RD STE C",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263450",
            "telephone_number": "414-400-6556",
            "fax_number": "414-400-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYDANIUK",
        "first_name": "KATELYN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "1508624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kathryn Maxey, R.D.
• Maxim Healthcare Services, Inc.
• Jennifer L Maxwell, LCSW
• Korrin May-Bretl, PTA
• Michelle J May, D.M.D.
• Mayfaif Family Dentistry
• Mayfair Dental Care: Implants, Oral Surgery and Family Dental S.C.
• Mayfair Digestive Health Center, LLC
• Mayfair Family Dentistry
• Mayfair Foot Care Clinic S.C.

• Physical Therapist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.