Active NPI
Elizabeth Udovich, DPT
- Neurology Physical Therapist
- Brookfield, WI
National Provider Identifier
1144788381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physical Therapist
- Practice address
- 21700 Intertech Dr
Brookfield, WI 53045-5197 - Phone
- (262) 532-8628
- NPI assigned
- Mar 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physical Therapist | 2251N0400X | Primary |
Addresses
Primary practice location
21700 Intertech Dr
Brookfield, WI 53045-5197
Mailing address
1707 Coldwater Creek Dr
Waukesha, WI 53188-8029
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1701 Fond Du Lac Ave
Kewaskum, WI 53040-9129
Phone (262) 626-4616
W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11602 | WI | MD | Dental Hygienist |
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.
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551830400000",
"number": "1144788381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1707 COLDWATER CREEK DR",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531888029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21700 INTERTECH DR",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530455197",
"telephone_number": "262-532-8628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDOVICH",
"first_name": "ELIZABETH",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-06",
"last_updated": "2019-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": null,
"license": null,
"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 Mar 6, 2019; 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.