Individual provider Active NPI

Susan M. Fitzpatrick, P.T.

  • Physical Therapist
  • Menomonee Falls, WI
National Provider Identifier
1114959756
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5397 Issued in WI
Practice address
N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810
Phone
(262) 251-7500
Fax
(262) 251-7128
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5397 WI Primary

Addresses

Primary practice location

N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810

Mailing address

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Other identifiers 2

IdentifierTypeStateIssuer
40366600MedicaidWI
392626639000OtherWIBLUE CROSS BLUE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5397WIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Healthcare SC Past Accepting new patients
Aurora Advanced Healthcare, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114959756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W GOOD HOPE RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092042",
            "telephone_number": "414-352-3100",
            "fax_number": "414-247-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N84W16889 MENOMONEE AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512810",
            "telephone_number": "262-251-7500",
            "fax_number": "262-251-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40366600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "392626639000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, 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.

Verify at the official NPI Registry.