NPIMap

Organization Active NPI

Marquette University

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1396020194
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MARQUETTE UNIVERSITY
Practice address
604 N 16TH St RM 215
Milwaukee, WI 53233-2117
Phone
(414) 288-1400
Fax
(414) 293-5509
NPI assigned
Oct 13, 2011
Last updated
Nov 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Authorized official

Name
Ms. William Cullinan
Title
Dean of College of Health Sciences
Phone
(414) 288-1400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

604 N 16TH St RM 215
Milwaukee, WI 53233-2117

Mailing address

604 N 16TH St RM 215
Milwaukee, WI 53233-2117
Phone (414) 288-1400

Other practice location 1

604 N 16th St Rm 104
Milwaukee, WI 53233-2117
Phone (414) 288-6122

Other names 2

  • Marquette Neuro Recovery Clinic Other name
  • Marquette Physical Therapy Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170810000334 WI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0648221028 Receives reassigned benefits from 16 practitioners
Practice locations: Milwaukee, WI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Marquette University6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

604 N 16th St
Rm 104
Milwaukee, WI 53233
Phone (414) 288-1400

604 N 16th St
Rm 215
Milwaukee, WI 53233
Phone (414) 288-1400

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1396020194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N 16TH ST RM 215",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332117",
            "telephone_number": "414-288-1400",
            "fax_number": "414-288-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N 16TH ST RM 215",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332117",
            "telephone_number": "414-288-1400",
            "fax_number": "414-293-5509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "604 N 16th St Rm 104",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532332117",
            "country_code": "US",
            "telephone_number": "414-288-6122",
            "fax_number": "414-293-5512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARQUETTE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-13",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "CULLINAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DEAN OF COLLEGE OF HEALTH SCIENCES",
        "authorized_official_telephone_number": "414-288-1400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marquette Neuro Recovery Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Marquette Physical Therapy Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.