Active NPI
Bradley W Meyer, PT
- Physical Therapist
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11747-24
- Practice address
- 451 E Erie St
Milwaukee, WI 53202-6159 - Phone
- (414) 272-8482
- Fax
- (414) 272-2880
- NPI assigned
- Jul 1, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11747-24 | WI | Primary |
Addresses
Primary practice location
451 E Erie St
Milwaukee, WI 53202-6159
Mailing address
451 E Erie St
Milwaukee, WI 53202-6159
Phone (414) 272-8482
Other practice location 1
10460 W Innovation Dr # 102
Wauwatosa, WI 53226-4816
Phone (414) 563-1230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100016113 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- University of Wisconsin School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10460 W Innovation Dr
Suite 102
Wauwatosa, WI 53226-4881
Phone (414) 563-1230
451 E Erie St
Milwaukee, WI 53202-6159
Phone (414) 272-8482
5434 W Capitol Dr
Suite 3
Milwaukee, WI 53216-2298
Phone (414) 875-0505
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11747-24 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vita Physical Therapy SC | Physical Therapist | Current | Accepting new patients |
| Independent Physicians of Wisconsin, LLC | Current | Accepting new patients | |
| Independent Physicians of Wisconsin, LLC | Current | Accepting new patients |
Locations
451 E Erie St
Milwaukee, WI 53202
Phone (414) 272-8482
5434 W Capitol Dr
Ste 3
Milwaukee, WI 53216
Phone (414) 217-1229
136 N Main St
Ste 308
Thiensville, WI 53092
Phone (262) 478-0920
10460 W Innovation Dr
Ste 102
Wauwatosa, WI 53226
Phone (414) 563-1230
Interoperability endpoints
- bradley.meyer.1@18758.direct.athenahealth.com
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.
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1871975920
-
- Physical Therapy Clinic/Center
- Milwaukee, WI
- NPI 1255386454
Physical Therapist
-
- Durable Medical Equipment & Medical Supplies
- Kenosha, WI
- NPI 1588255996
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648771200000",
"number": "1215224928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "451 E ERIE ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532026159",
"telephone_number": "414-272-8482",
"fax_number": "414-272-2880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 E ERIE ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532026159",
"telephone_number": "414-272-8482",
"fax_number": "414-272-2880"
}
],
"practiceLocations": [
{
"address_1": "10460 W Innovation Dr # 102",
"address_purpose": "LOCATION",
"city": "Wauwatosa",
"state": "WI",
"postal_code": "532264816",
"country_code": "US",
"telephone_number": "414-563-1230",
"fax_number": "414-272-2880",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEYER",
"first_name": "BRADLEY",
"middle_name": "W",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-01",
"last_updated": "2022-04-01",
"certification_date": "2022-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "11747-24",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100016113",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.