NPIMap

Individual provider Active NPI

Bradley A Tythcott, PT

  • Physical Therapist
  • Sussex, WI
National Provider Identifier
1205892486
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9592 Issued in WI
Practice address
N53W24950 S Corporate Cir
Suite 2
Sussex, WI 53089-4374
Phone
(126) 224-6300
Fax
(262) 246-4255
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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 9592 WI Primary

Addresses

Primary practice location

N53W24950 S Corporate Cir
Suite 2
Sussex, WI 53089-4374

Mailing address

615 Quinlan Dr
Unit G
Pewaukee, WI 53072-1809
Phone (262) 746-9785

Other identifiers 1

IdentifierTypeStateIssuer
40465300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates Health Centers-Occupational Health Past Accepting new patients
Kurt a Simons, DC, SC Past Accepting new patients
Prohealth Medical Group Inc. Past Accepting new patients

Organizations & group practices 3

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1205892486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 QUINLAN DR",
            "address_2": "UNIT G",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530721809",
            "telephone_number": "262-746-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N53W24950 S CORPORATE CIR",
            "address_2": "SUITE 2",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530894374",
            "telephone_number": "126-224-6300",
            "fax_number": "262-246-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYTHCOTT",
        "first_name": "BRADLEY",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40465300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sussex, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.