Individual provider Active NPI

Marie Kujawa

  • Sports Physical Therapist
  • Hartford, WI
National Provider Identifier
1205227501
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
371-39 Issued in WI
Practice address
110 Lone Oak LN
Hartford Health Center
Hartford, WI 53027-2600
Phone
(262) 670-1800
Fax
(262) 836-1601
NPI assigned
Feb 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 371-39 WI Primary

Addresses

Primary practice location

110 Lone Oak LN
Hartford Health Center
Hartford, WI 53027-2600

Mailing address

110 Lone Oak LN
Hartford Health Center
Hartford, WI 53027-2600
Phone (262) 670-1800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160318001578 WI Practitioner - Physical Therapist in Private Practice 4981901949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

110 Lone Oak LN
Hartford, WI 53027-2600
Phone (262) 670-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
371-39WIMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 15, 2016 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 15, 2016 Accepting new patients

Locations

21700 Intertech Dr
Brookfield, WI 53045
Phone (262) 532-8300

1350 S Sunny Slope Rd
Brookfield, WI 53005
Phone (262) 798-8750

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

110 Lone Oak Ln
Hartford, WI 53027
Phone (262) 670-1800

W227N16857 Tillie Lake Ct
Jackson, WI 53037
Phone (262) 365-6170

W225N16711 Cedar Park Ct
Jackson, WI 53037
Phone (262) 323-9257

1701 Fond du Lac Ave
Kewaskum, WI 53040
Phone (262) 626-4616

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

N91W15750 Falls Pkwy
Menomonee Falls, WI 53051
Phone (262) 532-1100

11430 N Port Washington Rd
Mequon, WI 53092
Phone (262) 518-1900

1271 N 6th St
Milwaukee, WI 53212
Phone (414) 978-9037

4805 S Moorland Rd
New Berlin, WI 53151
Phone (262) 798-7200

7901 S 6th St
Oak Creek, WI 53154
Phone (414) 346-8000

2315 E Moreland Blvd
Waukesha, WI 53186
Phone (262) 532-5700

W234S3555 State Road 59
Waukesha, WI 53189
Phone (262) 349-9297

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

1190 E Paradise Dr
West Bend, WI 53095
Phone (262) 306-6319

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

6255 N Santa Monica Blvd
Whitefish Bay, WI 53217
Phone (414) 967-8256

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": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1205227501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LONE OAK LN",
            "address_2": "HARTFORD HEALTH CENTER",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "530272600",
            "telephone_number": "262-670-1800",
            "fax_number": "262-836-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LONE OAK LN",
            "address_2": "HARTFORD HEALTH CENTER",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "530272600",
            "telephone_number": "262-670-1800",
            "fax_number": "262-836-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUJAWA",
        "first_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "WI",
            "license": "371-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.