Active NPI
David Arthur Peterson, PT
- Physical Therapist
- Port Washington, WI
National Provider Identifier
1215971627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3553
- Practice address
- 1317 W Grand Ave
Port Washington, WI 53074-2075 - Phone
- (262) 284-2261
- NPI assigned
- Jun 15, 2006
- Last updated
- Jul 13, 2026
- 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 | 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
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3553 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitation Institute of Wisconsin, Inc. | Past | 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.
-
- Multi-Specialty Clinic/Center
- Milwaukee, WI
- NPI 1497768659
-
- Rehabilitation Clinic/Center
- Brookfield, WI
- NPI 1477750255
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.