Kurtis J Sustachek, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14727 Issued in WI

Practice address

1813 Ashland Ave
Sheboygan, WI 53081-6125

Phone

(920) 458-4010

NPI assigned

Jun 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  NPD

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1396305330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-389-2338",
            "fax_number": "414-385-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 ASHLAND AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530816125",
            "telephone_number": "920-458-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSTACHEK",
        "first_name": "KURTIS",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-20",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksustachek230349@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1813 Ashland Ave",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530816125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1813 Ashland Ave",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530816125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sunny Ridge Health and Rehabilitation Center
• Sunny Ridge Nursing and Rehabilitation Center, LLC
• Sunny Ridge Operations LLC
• Sunny Ridge Rehabilitation Center LLC
• Surgery Center of Sheboygan LLC
• Sanjay Bhikhalal Suthar, MD
• Jamie Swifka
• Nouman Syed, M.D.
• Jenna L Tadych, COTA
• Martha Taran, MD

• Physical Therapist in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.