Individual provider Active NPI

Amanda Gaska, DPT

  • Physical Therapist
  • Brookfield, WI
National Provider Identifier
1245692821
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12779 Issued in WI
Practice address
19525 W North Ave
Brookfield, WI 53045-4107
Phone
(262) 780-3813
NPI assigned
Mar 23, 2016
Last updated
Mar 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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 12779 WI Primary

Addresses

Primary practice location

19525 W North Ave
Brookfield, WI 53045-4107

Mailing address

19525 W North Ave
Brookfield, WI 53045-4107
Phone (262) 780-3813

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180622001866 WI Practitioner - Physical Therapist in Private Practice 9537414131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7901 S 6TH St
Oak Creek, WI 53154-2010
Phone (414) 346-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients
The Medical College of Wisconsin, Inc. Physical Therapist Current Accepting new patients

Locations

19525 W North Ave
Brookfield, WI 53045
Phone (262) 785-1114

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

7901 S 6th St
Oak Creek, WI 53154
Phone (414) 346-8000

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

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, 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": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1245692821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19525 W NORTH AVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454107",
            "telephone_number": "262-780-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19525 W NORTH AVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454107",
            "telephone_number": "262-780-3813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASKA",
        "first_name": "AMANDA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.