NPIMap

Organization Active NPI

Optimum Therapies, LLC

  • Physical Medicine & Rehabilitation Physician
  • Menomonie, WI
National Provider Identifier
1356463087
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5270-024 Issued in WI
Legal business name
OPTIMUM THERAPIES, LLC
Practice address
1309 Stout Rd
Menomonie, WI 54751-2959
Phone
(715) 233-6230
Fax
(715) 233-6231
NPI assigned
Apr 4, 2007
Last updated
Sep 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Authorized official

Name
Jodi Dresen
Title
Revenue Cycle Manager
Phone
(715) 607-1758

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU
Physical Medicine & Rehabilitation Physician 208100000X 5270-024 WI Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

1309 Stout Rd
Menomonie, WI 54751-2959

Mailing address

1309 Stout Rd
Menomonie, WI 54751-2959
Phone (715) 233-6230

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040228000087 WI Part B Supplier - Clinic/Group Practice 3375430028 Receives reassigned benefits from 16 practitioners
6 other NPIs on this enrollment
Practice locations: Chippewa Falls, WI; Bloomer, WI; Menomonie, WI; Eau Claire, WI

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Optimum Therapies LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

517 E Clairemont Ave
Eau Claire, WI 54701
Phone (715) 855-0408

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1356463087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 STOUT RD",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512959",
            "telephone_number": "715-233-6230",
            "fax_number": "715-233-6231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 STOUT RD",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512959",
            "telephone_number": "715-233-6230",
            "fax_number": "715-233-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM THERAPIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "DRESEN",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "715-607-1758"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "5270-024",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.