NPIMap

Organization Active NPI

Orthopedic & Spine Therapy of Menasha SC

  • Physical Therapist
  • Menasha, WI
National Provider Identifier
1205863602
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ORTHOPEDIC & SPINE THERAPY OF MENASHA SC
Practice address
1000 Midway Rd
Menasha, WI 54952-1116
Phone
(920) 727-9878
Fax
(920) 727-9903
NPI assigned
Jun 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Authorized official

Name
Paul Steven Barnett, PTNPI 1154368777
Title
Owner-President
Phone
(920) 257-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X WI Primary

Addresses

Primary practice location

1000 Midway Rd
Menasha, WI 54952-1116

Mailing address

1000 Midway Rd
Menasha, WI 54952-1116
Phone (920) 257-2000

Other identifiers 6

IdentifierTypeStateIssuer
40416400MedicaidWI
CH3738OtherWIRAILROAD MEDICARE
102382900OtherWIUS DEPARTMENT OF LABOR
128871OtherWIHEALTH PARTNERS
4136286002OtherWIAMERICHOICE
41745500MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204001068 WI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8123923869 Receives reassigned benefits from 31 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Menasha, WI; Appleton, WI; Kaukauna, WI

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Orthopedic Spine Therapy of Menasha SC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1205863602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521116",
            "telephone_number": "920-257-2000",
            "fax_number": "920-257-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521116",
            "telephone_number": "920-727-9878",
            "fax_number": "920-727-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC & SPINE THERAPY OF MENASHA SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER-PRESIDENT",
        "authorized_official_telephone_number": "920-257-2000",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40416400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH3738",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "102382900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "128871",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "4136286002",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41745500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menasha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; 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.