Individual provider Active NPI

Cassidy Jean Mrotek

  • Physical Therapist
  • New Berlin, WI
National Provider Identifier
1184351553
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5330 S Racine Ave
New Berlin, WI 53146-3933
Phone
(262) 682-4919
NPI assigned
Aug 4, 2022
Last updated
Jun 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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 WI Primary

Addresses

Primary practice location

5330 S Racine Ave
New Berlin, WI 53146-3933

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221005001704 WI Practitioner - Physical Therapist in Private Practice 7315323904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist CurrentSince Sep 16, 2022 Accepting new patients
Orthopaedic Associates of Wisconsin, SC CurrentSince Sep 16, 2022 Accepting new patients
Orthopaedic Associates of Wisconsin SC CurrentSince Sep 16, 2022 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist CurrentSince Sep 16, 2022 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

285 S Moorland Rd
Brookfield, WI 53005
Phone (810) 331-0939

S74W16867 Janesville Rd
Muskego, WI 53150
Phone (262) 971-4200

5330 S Racine Ave
New Berlin, WI 53146
Phone (262) 682-4919

N15W28300 Golf Rd
Pewaukee, WI 53072

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1184351553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 S RACINE AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531463933",
            "telephone_number": "262-682-4919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N15W28300 Golf Rd",
            "address_purpose": "LOCATION",
            "city": "Pewaukee",
            "state": "WI",
            "postal_code": "530724800",
            "country_code": "US",
            "telephone_number": "262-303-5055",
            "fax_number": "262-303-5057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MROTEK",
        "first_name": "CASSIDY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.