Individual provider Active NPI

David L Graziano, P.T.

  • Physical Therapist
  • Oak Creek, WI
National Provider Identifier
1386708840
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3435-024 Issued in WI
Practice address
2333 West Ryan Road
Oak Creek, WI 53154
Phone
(877) 552-2996
Fax
(866) 245-8064
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

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 3435-024 WI Primary

Addresses

Primary practice location

2333 West Ryan Road
Oak Creek, WI 53154

Mailing address

P.O. Box 3497
Sturtevant, WI 53177
Phone (877) 552-2996

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110000183 WI Practitioner - Physical Therapist in Private Practice 2264455823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DPT Holdings LLCGroup PAC ID 4688679293, 170 clinicians

Practice addresses (Care Compare)

3825 39TH Ave
Suite 110
Kenosha, WI 53144-2043
Phone (800) 974-4378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3435WIMDOptometrist
3435-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DPT Holdings, LLC Physical Therapist CurrentSince Jul 30, 2012 Accepting new patients
Sports Physical Therapy & Rehab Specialists, S.C. Physical Therapist Past Accepting new patients

Locations

10320 75th St
Ste D
Kenosha, WI 53142
Phone (262) 909-2820

10105 74th St
Ste 103
Kenosha, WI 53142
Phone (262) 697-6143

3825 39th Ave
Ste 110
Kenosha, WI 53144
Phone (262) 605-6810

Organizations & group practices 2

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219622400000",
    "number": "1386708840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3497",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "53177",
            "telephone_number": "877-552-2996",
            "fax_number": "866-245-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 WEST RYAN ROAD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "53154",
            "telephone_number": "877-552-2996",
            "fax_number": "866-245-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAZIANO",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2008-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3435-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Creek, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.