Individual provider Active NPI

Paula Marie Heller, MPT

  • Physical Therapist
  • Plymouth, WI
National Provider Identifier
1285847228
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10297-024 Issued in WI
Practice address
1505 Eastern Ave
Plymouth, WI 53073-2020
Phone
(920) 893-6070
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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 10297-024 WI Primary

Addresses

Primary practice location

1505 Eastern Ave
Plymouth, WI 53073-2020

Mailing address

N1476 Pfister LN
Kiel, WI 53042-9521
Phone (920) 894-1102

Other identifiers 1

IdentifierTypeStateIssuer
36107900MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160520000166 WI Practitioner - Physical Therapist in Private Practice 9234428863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Focus Physical Therapy LLCGroup PAC ID 5597716738, 3 clinicians

Practice addresses (Care Compare)

1505 Eastern Ave
Plymouth, WI 53073-2020
Phone (920) 893-6070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10297-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Focus Physical Therapy LLC Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients

Locations

1505 Eastern Ave
Plymouth, WI 53073
Phone (920) 893-6070

Organizations & group practices 1

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1285847228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N1476 PFISTER LN",
            "city": "KIEL",
            "state": "WI",
            "postal_code": "530429521",
            "telephone_number": "920-894-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EASTERN AVE",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530732020",
            "telephone_number": "920-893-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "PAULA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10297-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36107900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.