NPIMap

Organization Active NPI

Orthopaedic Centers of Wisconsin S C

  • Occupational Therapist
  • Wausau, WI
National Provider Identifier
1174977433
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
ORTHOPAEDIC CENTERS OF WISCONSIN S C
Practice address
3901 Stewart Ave
Wausau, WI 54401-3948
Phone
(715) 907-0900
NPI assigned
Apr 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Authorized official

Name
Shane Melenbacker
Title
Administrator
Phone
(715) 344-2167

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X

Addresses

Primary practice location

3901 Stewart Ave
Wausau, WI 54401-3948

Mailing address

3901 Stewart Ave
Wausau, WI 54401-3948
Phone (715) 907-0900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040827000278 WI Part B Supplier - Clinic/Group Practice 4981679552 Receives reassigned benefits from 58 practitioners
4 other NPIs on this enrollment
Practice locations: Stevens Point, WI; Wausau, WI; Weston, WI

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3901 Stewart Ave
Wausau, WI 54401
Phone (715) 841-0002

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1174977433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 STEWART AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013948",
            "telephone_number": "715-907-0900",
            "fax_number": "715-803-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 STEWART AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013948",
            "telephone_number": "715-907-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC CENTERS OF WISCONSIN S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-22",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "MELENBACKER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "715-344-2167"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.