John R Brushert, PT, DPT
Individual provider Active NPI Physical Therapist · Stratford, WI
NPI 1316728801 · NPPES record last updated Oct 10, 2023
Key facts
- NPI
- 1316728801
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 16479-24 (WI)
- Practice address
- 213016 Legion Street
Stratford, WI 54484-5028 - Phone
- (800) 974-4378
- Fax
- (630) 515-1536
- NPI assigned
- Oct 10, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DPT Holdings LLC
Practice addresses (Care Compare)
213016 Legion St
Stratford, WI 54484-5028
Phone (800) 974-4378
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231127001927 | WI | Practitioner - Physical Therapist in Private Practice | 6103274451 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16479-24 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DPT Holdings PLLC | Physical Therapist | Current |
Accepting new patients |
Locations
24014 W Renwick Rd
Ste 206
Plainfield, IL 60544
3825 39th Ave
Ste 110
Kenosha, WI 53144
Phone (262) 605-6810
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 16479-24 | WI | Yes |
Addresses
Primary practice location
213016 Legion Street
Stratford, WI 54484-5028
Mailing address
24014 W Renwick Rd Unit 206
Plainfield, IL 60544-8711
Phone (800) 974-4378
Other providers in Stratford, WI
- Align Wellness Center LLC
- Amber Marie Bergman
- Brenda Kaye Castellano
- Marilyn R Dean
- Janice Lorraine Devine-Ruggles
- Corina Marie Dickmann
- Eric Raymond Dickmann
All providers in Stratford, 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 Oct 10, 2023. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.