Individual provider Active NPI

Amie L Sutheimer, OTR

  • Occupational Therapist
  • Menomonee Falls, WI
National Provider Identifier
1124229661
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2635-026 Issued in WI
Practice address
N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810
Phone
(262) 251-7500
Fax
(262) 532-1396
NPI assigned
May 31, 2007
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2635-026 WI Primary

Addresses

Primary practice location

N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (262) 251-7500

Other practice location 1

1640 East Sumner Street
Hartford, WI 53027-9014
Phone (262) 670-4300

Other identifiers 1

IdentifierTypeStateIssuer
40904900MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address asutheimer13635@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200504000733 WI Practitioner - Occupational Therapist in Private Practice 7214368455 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2635WIMDChiropractor
2635-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. CurrentSince Apr 22, 2020 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Apr 22, 2020 Accepting new patients

Locations

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

1640 E Sumner St
Hartford, WI 53027
Phone (262) 670-4000

N84W16889 Menomonee Ave
Menomonee Fls, WI 53051
Phone (262) 251-7500

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

Interoperability endpoints

  • Direct secure messaging: asutheimer13635@direct.myadvocateaurora.org

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1124229661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "262-251-7500",
            "fax_number": "262-532-1396"
        },
        {
            "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": "262-532-1396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1640 East Sumner Street",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "WI",
            "postal_code": "530279014",
            "country_code": "US",
            "telephone_number": "262-670-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTHEIMER",
        "first_name": "AMIE",
        "middle_name": "L",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "2635-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40904900",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asutheimer13635@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "N84W16889 Menomonee Ave",
            "city": "Menomonee Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530512810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "N84W16889 Menomonee Ave",
            "city": "Menomonee Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530512810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.