Individual provider Active NPI

Deanna Elliott Aussprung, PT, LAT, CSCS

  • Physical Therapist
  • Madison, WI
National Provider Identifier
1174747208
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2580-24 Issued in WI
Practice address
313 Junction Rd
Madison, WI 53717-2613
Phone
(608) 658-5352
Fax
(888) 965-4018
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 45039 WI
Physical Therapist 225100000X 2580-24 WI Primary

Addresses

Primary practice location

313 Junction Rd
Madison, WI 53717-2613

Mailing address

4834 Morris CT
Waunakee, WI 53597-9163
Phone (608) 658-5352

Other practice location 1

301 E 3rd St
Waunakee, WI 53597-2436
Phone (608) 658-5352

Other practice location 2

5477 Westshire Cir
Waunakee, WI 53597-9021
Phone (608) 658-5352

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040220001050 WI Practitioner - Physical Therapist in Private Practice 4082508973

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4834 Morris CT
Waunakee, WI 53597-9163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
45039WIMDAnesthesiology Physician
2580-24WIMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1174747208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4834 MORRIS CT",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "535979163",
            "telephone_number": "608-658-5352",
            "fax_number": "888-965-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 JUNCTION RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537172613",
            "telephone_number": "608-658-5352",
            "fax_number": "888-965-4018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Waunakee",
            "state": "WI",
            "postal_code": "535972436",
            "country_code": "US",
            "telephone_number": "608-658-5352",
            "fax_number": "888-965-4018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5477 Westshire Cir",
            "address_purpose": "LOCATION",
            "city": "Waunakee",
            "state": "WI",
            "postal_code": "535979021",
            "country_code": "US",
            "telephone_number": "608-658-5352",
            "fax_number": "888-965-4018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUSSPRUNG",
        "first_name": "DEANNA",
        "middle_name": "ELLIOTT",
        "name_prefix": "Mrs.",
        "credential": "PT, LAT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "45039",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2580-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.