Individual provider Active NPI

Vincent D Dray, DPT

  • Physical Therapist
  • West Allis, WI
National Provider Identifier
1154083053
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15412-24 Issued in WI
Practice address
8800 W Lincoln Ave
West Allis, WI 53227-2400
Phone
(414) 541-1118
Fax
(414) 541-3066
NPI assigned
Oct 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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 15412-24 WI Primary

Addresses

Primary practice location

8800 W Lincoln Ave
West Allis, WI 53227-2400

Mailing address

8800 W Lincoln Ave
West Allis, WI 53227-2400
Phone (414) 541-1118

Other practice location 1

7708 W Good Hope Rd
Milwaukee, WI 53223-4516
Phone (414) 541-1118

Other practice location 2

2121 S Kinnickinnic Ave Ste 3
Milwaukee, WI 53207-1368
Phone (414) 744-0707

Other practice location 3

613 W Michigan Ave
Suite 300
Milwaukee, WI 53208-5320
Phone (414) 344-4100

Other identifiers 1

IdentifierTypeStateIssuer
15615OtherWILICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211015001474 WI Practitioner - Physical Therapist in Private Practice 0941608335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thera-Dynamics SCGroup PAC ID 8820010317, 11 clinicians

Practice addresses (Care Compare)

8800 W Lincoln Ave
West Allis, WI 53227-2400
Phone (414) 541-1118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15412-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thera-Dynamics, S.C. Physical Therapist CurrentSince Sep 16, 2021 Accepting new patients
Southern Lakes Physical Therapy CurrentSince Sep 16, 2021 Accepting new patients

Locations

7708 W Good Hope Rd
Milwaukee, WI 53223
Phone (414) 541-1118

613 N 36th St
Unit 300
Milwaukee, WI 53208
Phone (414) 344-4100

2121 S Kinnickinnic Ave
Ste 3
Milwaukee, WI 53207
Phone (414) 541-1118

8800 W Lincoln Ave
West Allis, WI 53227
Phone (414) 541-1118

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": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1154083053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272400",
            "telephone_number": "414-541-1118",
            "fax_number": "414-541-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272400",
            "telephone_number": "414-541-1118",
            "fax_number": "414-541-3066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7708 W Good Hope Rd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532234516",
            "country_code": "US",
            "telephone_number": "414-541-1118",
            "fax_number": "414-541-3066",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2121 S Kinnickinnic Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532071368",
            "country_code": "US",
            "telephone_number": "414-744-0707",
            "fax_number": "414-744-0708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "613 W Michigan Ave",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532085320",
            "country_code": "US",
            "telephone_number": "414-344-4100",
            "fax_number": "414-344-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAY",
        "first_name": "VINCENT",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15412-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "15615",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.