Individual provider Active NPI

Bradley W Meyer, PT

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1215224928
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11747-24 Issued in WI
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

Updated by the provider on Apr 1, 2022

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 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

IdentifierTypeStateIssuer
100016113MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140612000283 WI Practitioner - Physical Therapist in Private Practice 0446474589 Reassigns benefits to 2 organizations

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
Independent Physicians of Wisconsin LLCGroup PAC ID 3274842034, 42 clinicians
Vita Physical Therapy SCGroup PAC ID 4981667235, 5 clinicians

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

LicenseStateTypeSpecialty
11747-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vita Physical Therapy SC Physical Therapist CurrentSince May 26, 2014 Accepting new patients
Independent Physicians of Wisconsin, LLC CurrentSince Jul 1, 2025 Accepting new patients
Independent Physicians of Wisconsin, LLC CurrentSince Jul 1, 2025 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

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.