Individual provider Active NPI

Sandra Christie Moloney, P.T.

  • Physical Therapist
  • Brookfield, WI
National Provider Identifier
1356692537
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9657-24 Issued in WI
Practice address
600 N Barker Rd
Brookfield, WI 53045-5919
Phone
(262) 432-3027
Fax
(262) 797-0730
NPI assigned
Sep 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9657-24 WI Primary

Addresses

Primary practice location

600 N Barker Rd
Brookfield, WI 53045-5919

Mailing address

13825 W Burleigh Rd
Brookfield, WI 53005-3058
Phone (262) 754-3450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121127000728 WI Practitioner - Physical Therapist in Private Practice 0345491239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keystone Physical Therapy LLCGroup PAC ID 6103236187, 5 clinicians

Practice addresses (Care Compare)

19265 W Capitol Dr
Suite L01
Brookfield, WI 53045-2740
Phone (262) 790-5775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9657-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Physical Therapy LLC Physical Therapist CurrentSince Oct 18, 2021 Accepting new patients
Wisconsin Luna Care Physical Therapy LLC Physical Therapist CurrentSince May 7, 2021 Accepting new patients
LHCG Xlvii, LLC PastSince Oct 18, 2021 Accepting new patients

Locations

19265 W Capitol Dr
Ste L01
Brookfield, WI 53045
Phone (262) 641-0459

525 Junction Rd
Ste 6500
Madison, WI 53717
Phone (608) 295-0109

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": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1356692537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13825 W BURLEIGH RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053058",
            "telephone_number": "262-754-3450",
            "fax_number": "262-754-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N BARKER RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455919",
            "telephone_number": "262-432-3027",
            "fax_number": "262-797-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLONEY",
        "first_name": "SANDRA",
        "middle_name": "CHRISTIE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9657-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.