Individual provider Active NPI

David Arthur Peterson, PT

  • Physical Therapist
  • Port Washington, WI
National Provider Identifier
1215971627
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3553 Issued in WI
Practice address
1317 W Grand Ave
Port Washington, WI 53074-2075
Phone
(262) 284-2261
NPI assigned
Jun 15, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 3553 WI Primary

Addresses

Primary practice location

1317 W Grand Ave
Port Washington, WI 53074-2075

Mailing address

W66N764 Madison Ave
Cedarburg, WI 53012-1151
Phone (262) 376-9175

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071214000548 WI Practitioner - Physical Therapist in Private Practice 9335239292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wisconsin Health FundGroup PAC ID 3072401298, 27 clinicians

Practice addresses (Care Compare)

6200 W Bluemound Rd
Milwaukee, WI 53213-4145
Phone (414) 771-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3553WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Institute of Wisconsin, Inc. PastSince Feb 10, 2011 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1215971627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W66N764 MADISON AVE",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530121151",
            "telephone_number": "262-376-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 W GRAND AVE",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530742075",
            "telephone_number": "262-284-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DAVID",
        "middle_name": "ARTHUR",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.