Individual provider Active NPI

Alec Christopher Brew, DPT

  • Physical Therapist
  • Bellevue, WI
National Provider Identifier
1336716349
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16421-24 Issued in WI
Practice address
2394 Costco Way Ste 120
Bellevue, WI 54311-9226
Phone
(920) 321-0348
Fax
(920) 888-4272
NPI assigned
Jun 8, 2021
Last updated
Jun 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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 019291 OH
Physical Therapist 225100000X 16421-24 WI Primary

Addresses

Primary practice location

2394 Costco Way Ste 120
Bellevue, WI 54311-9226

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

4686 Belmont Ave
Youngstown, OH 44505-1012
Phone (330) 423-4795

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230724000630 WI Practitioner - Physical Therapist in Private Practice 4183026156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2394 Costco Way
Suite 120
Bellevue, WI 54311-9207
Phone (920) 321-0348

Merit-based Incentive Payment System (MIPS)

Final score
83.05 of 100Reported as group
Quality
88.38
Improvement activities
40
Cost
64.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019291OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist CurrentSince Jun 21, 2023 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist CurrentSince Jun 21, 2023 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

2304 Lineville Rd
Ste 112
Green Bay, WI 54313
Phone (920) 321-0351

2394 Costco Way
Ste 120
Green Bay, WI 54311
Phone (920) 321-0348

S74W16867 Janesville Rd
Muskego, WI 53150
Phone (262) 971-4200

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": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1336716349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2394 COSTCO WAY STE 120",
            "city": "BELLEVUE",
            "state": "WI",
            "postal_code": "543119226",
            "telephone_number": "920-321-0348",
            "fax_number": "920-888-4272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4686 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445051012",
            "country_code": "US",
            "telephone_number": "330-423-4795",
            "fax_number": "330-953-0650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREW",
        "first_name": "ALEC",
        "middle_name": "CHRISTOPHER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "019291",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16421-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.