Individual provider Active NPI

Anne Hartay, DPT

  • Physical Therapist
  • Brookfield, WI
National Provider Identifier
1134919459
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17466-24 Issued in WI
Practice address
12635 W North Ave
Brookfield, WI 53005-4629
Phone
(414) 431-8115
NPI assigned
May 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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 17466-24 WI Primary

Addresses

Primary practice location

12635 W North Ave
Brookfield, WI 53005-4629

Mailing address

12635 W North Ave
Brookfield, WI 53005-4629
Phone (414) 431-8115

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250623001933 WI Practitioner - Physical Therapist in Private Practice 9638681075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Evolve Physical Therapy and Sports Medicine LLCGroup PAC ID 6204298029, 3 clinicians

Practice addresses (Care Compare)

12635 W N Ave
Brookfield, WI 53005-4629
Phone (414) 431-8115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17466-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Physical Therapy and Sports Medicine LLC Physical Therapist CurrentSince May 14, 2025 Accepting new patients

Locations

12635 W North Ave
Brookfield, WI 53005
Phone (414) 431-8115

Organizations & group practices 1

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": "1746748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1134919459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12635 W NORTH AVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054629",
            "telephone_number": "414-431-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12635 W NORTH AVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054629",
            "telephone_number": "414-431-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTAY",
        "first_name": "ANNE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-09",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "17466-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.