Individual provider Active NPI

Konrad Wiese, PTA

  • Physical Therapy Assistant
  • Valparaiso, IN
National Provider Identifier
1376412734
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06007026A Issued in IN
Practice address
3538 Calumet Ave
Valparaiso, IN 46383-2246
Phone
(219) 316-7470
Fax
(219) 386-2505
NPI assigned
Nov 3, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06007026A IN Primary

Addresses

Primary practice location

3538 Calumet Ave
Valparaiso, IN 46383-2246

Mailing address

23 Paisley GRN
Valparaiso, IN 46385-9277
Phone (219) 263-9391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
06007026AINMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Solutions LLC CurrentSince Nov 9, 2025 Accepting new patients

Locations

3538 Calumet Ave
Valparaiso, IN 46383
Phone (219) 316-7470

Organizations & group practices 1

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": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1376412734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 PAISLEY GRN",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463859277",
            "telephone_number": "219-263-9391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3538 CALUMET AVE",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832246",
            "telephone_number": "219-316-7470",
            "fax_number": "219-386-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "KONRAD",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06007026A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.