Timothy G Dellemann, PT
Individual provider Active NPI Physical Therapist · Hartford, WI
NPI 1225316342 · NPPES record last updated Dec 8, 2021
Key facts
- NPI
- 1225316342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11844 (WI)
- Practice address
- 1640 E Sumner St
Hartford, WI 53027-2684 - Phone
- (262) 670-4300
- NPI assigned
- Jul 22, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110929000722 | WI | Practitioner - Physical Therapist in Private Practice | 5991977688 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Advanced Healthcare Inc | Current |
Accepting new patients | |
| Aurora Advanced Healthcare, Inc. | Current |
Accepting new patients |
Locations
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
1640 E Sumner St
Hartford, WI 53027
Phone (262) 670-4000
1032 E Sumner St
Hartford, WI 53027
Phone (262) 670-4300
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
Interoperability endpoints
- tdellemann15420@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11844 | WI | Yes |
Addresses
Primary practice location
1640 E Sumner St
Hartford, WI 53027-2684
Mailing address
1640 E Sumner St
Hartford, WI 53027-2684
Phone (262) 670-4300
Other practice location 1
1032 E Sumner St
Hartford, WI 53027-1608
Phone (262) 673-2300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01077547 | Other | WI | RR MEDICARE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tdellemann15420@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Hartford, WI
- Kathryn Marie Davies
- James H Davis
- Ladonna Davis
- Eric J Dean
- Jennifer Lynn Delaruelle
- Agnes P Dietenberger
- Joshua Dilday
- Luann L Doll
- Jennifer Lyn Donath
- Keith J Doubleday
All providers in Hartford, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.