Active NPI
Breanne N Beres, DPT, ATC
- Physical Therapist
- Port Washington, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13882
- Practice address
- 1475 W Grand Ave
Port Washington, WI 53074-2074 - Phone
- (262) 268-5100
- NPI assigned
- Jun 15, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 13882 | WI | Primary |
Addresses
Primary practice location
1475 W Grand Ave
Port Washington, WI 53074-2074
Mailing address
1475 W Grand Ave
Port Washington, WI 53074-2074
Phone (262) 268-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06152018736054 | Medicaid | WI |
Other names 1
- Breanne N Geipel
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | bgeipel189671@direct.myadvocateaurora.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1475 W Grand Ave
Port Washington, WI 53074-2074
Phone (262) 268-5100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13882 | WI | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freedom Physical Therapy Services SC | Physical Therapist | Current | Accepting new patients |
| Aurora Advanced Healthcare, Inc. | Current | Accepting new patients | |
| Aurora Advanced Healthcare Inc | Current | Accepting new patients |
Locations
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
1235 Dakota Dr
Ste L
Grafton, WI 53024
Phone (262) 376-2085
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233
6908 N Santa Monica Blvd
Milwaukee, WI 53217
Phone (414) 352-2082
1475 W Grand Ave
Port Washington, WI 53074
Phone (262) 268-5100
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.
-
- Family Medicine Physician
- Milwaukee, WI
- NPI 1265629133
-
- Physical Therapist
- Fox Point, WI
- NPI 1063406544
-
- Durable Medical Equipment & Medical Supplies
- Summit, WI
- NPI 1477186633
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641254400000",
"number": "1396239182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1475 W GRAND AVE",
"city": "PORT WASHINGTON",
"state": "WI",
"postal_code": "530742074",
"telephone_number": "262-268-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1475 W GRAND AVE",
"city": "PORT WASHINGTON",
"state": "WI",
"postal_code": "530742074",
"telephone_number": "262-268-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERES",
"first_name": "BREANNE",
"middle_name": "N",
"credential": "DPT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-15",
"last_updated": "2022-01-04",
"certification_date": "2022-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "13882",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06152018736054",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1475 W Grand Ave",
"city": "Port Washington",
"state": "WI",
"country_code": "US",
"postal_code": "530742074",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bgeipel189671@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1475 W Grand Ave",
"city": "Port Washington",
"state": "WI",
"country_code": "US",
"postal_code": "530742074",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "BREANNE",
"last_name": "GEIPEL",
"middle_name": "N",
"credential": "DPT,ATC",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Port Washington, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.