Individual provider Active NPI

Ty A Zimmerman, DPT

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1174014005
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3939 S 92ND St
Milwaukee, WI 53228-2140
Phone
(414) 321-1800
NPI assigned
May 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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 Primary

Addresses

Primary practice location

3939 S 92ND St
Milwaukee, WI 53228-2140

Mailing address

24014 W Renwick Rd
Ste F
Plainfield, IL 60544-8708
Phone (800) 974-4378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191125000648 WA Practitioner - Physical Therapist in Private Practice 3678905056 Reassigns benefits to 1 organization
I20210105000914 WI Practitioner - Physical Therapist in Private Practice 3678905056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

N2950 State Rd
Suite 67
Lake Geneva, WI 53147-2655
Phone (262) 245-0535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation Current Accepting new patients
Mercy Health System Corporation CurrentSince Sep 7, 2021 Accepting new patients
Mercy Health System Corporation CurrentSince Sep 7, 2021 Accepting new patients
Multicare Health System CurrentSince Sep 17, 2019 Accepting new patients
Multicare Health System CurrentSince Sep 17, 2019 Accepting new patients
Multicare Health System Current Accepting new patients
Mercy Harvard Hospital Inc Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

8011 112th Street Ct E
Puyallup, WA 98373
Phone (253) 848-0662

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

350 Peller Rd
Lake Geneva, WI 53147
Phone (262) 245-0221

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

Interoperability endpoints

  • Direct secure messaging: tzimmerman84433@direct.mhemail.org

Organizations & group practices 7

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": "1527292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1174014005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24014 W RENWICK RD",
            "address_2": "STE F",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448708",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 S 92ND ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532282140",
            "telephone_number": "414-321-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "TY",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-26",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.