Individual provider Active NPI

Tiffany Susan Virag, DPT

  • Physical Therapist
  • Madison, WI
National Provider Identifier
1285859405
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10862-24 Issued in WI
Practice address
44 E Mifflin St
Suite 10
Madison, WI 53703-4205
Phone
(608) 957-7088
NPI assigned
Apr 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 011385 OH
Physical Therapist 225100000X 1760332 MI
Physical Therapist 225100000X 10862-24 WI Primary

Addresses

Primary practice location

44 E Mifflin St
Suite 10
Madison, WI 53703-4205

Mailing address

44 E Mifflin St
Suite 10
Madison, WI 53703-4205
Phone (608) 957-7088

Other identifiers 3

IdentifierTypeStateIssuer
TVIRAGMedicaidOH
TVIRAGMedicaidMI
1285859405MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090721000049 WI Practitioner - Physical Therapist in Private Practice 5799836482 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1760332MIMDPhysical Therapist
011385OHMDPhysical Therapist
10862-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Physical Therapy & Consulting, LLC Physical Therapist CurrentSince Jul 1, 2016 Accepting new patients
Ampt Advanced Manual Physical Therapy Specialty PT Clinics, LLC Past Accepting new patients
Ampt Advanced Manual Physical Therapy Specialty PT Clinics, Inc. Past Accepting new patients

Locations

100 Wisconsin Ave
Ste 101
Madison, WI 53703
Phone (608) 957-7088

44 E Mifflin St
Ste 10
Madison, WI 53703
Phone (608) 957-7088

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1285859405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 E MIFFLIN ST",
            "address_2": "SUITE 10",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537034205",
            "telephone_number": "608-957-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 E MIFFLIN ST",
            "address_2": "SUITE 10",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537034205",
            "telephone_number": "608-957-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRAG",
        "first_name": "TIFFANY",
        "middle_name": "SUSAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-14",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "011385",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "1760332",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10862-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TVIRAG",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TVIRAG",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285859405",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.