Individual provider Active NPI

Jared Hoffmann, DPT

  • Physical Therapist
  • Green Bay, WI
National Provider Identifier
1306498613
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15290 Issued in WI
Practice address
1160 Kepler Dr
Green Bay, WI 54311-8321
Phone
(920) 288-5578
NPI assigned
Jul 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11604 MN
Physical Therapist 225100000X 15290 WI Primary

Addresses

Primary practice location

1160 Kepler Dr
Green Bay, WI 54311-8321

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231027000902 AZ Practitioner - Physical Therapist in Private Practice 1658608427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHSM Rehabilitation LLCGroup PAC ID 2062773138, 450 clinicians

Practice addresses (Care Compare)

7400 N Dobson Rd
Suite 103
Scottsdale, AZ 85256-2769
Phone (602) 613-9133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15290WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
BHSM Rehabilitation LLC Physical Therapist CurrentSince Sep 16, 2023 Accepting new patients
BHSM Rehabilitation, LLC Current Accepting new patients
BHSM Rehabilitation, LLC CurrentSince Sep 16, 2023 Accepting new patients

Locations

3507 S Mercy Rd
Ste A
Gilbert, AZ 85297
Phone (480) 926-0404

2120 Airway Ave
Kingman, AZ 86409
Phone (928) 757-1211

4200 E Camelback Rd
Ste 103
Phoenix, AZ 85018
Phone (602) 858-3307

7400 N Dobson Rd
Ste 103
Scottsdale, AZ 85256
Phone (602) 613-9133

Organizations & group practices 4

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": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1306498613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118321",
            "telephone_number": "920-288-5578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOFFMANN",
        "first_name": "JARED",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11604",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.