Michael J Herlihy, PT

Key facts

NPI

1407080153

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

12772-24 (WI)

Practice address

2835 N Grandview Blvd Ste 100
Pewaukee, WI 53072-5546

Phone

(262) 574-1100

NPI assigned

May 11, 2009

Sex

Male

Sole proprietor

No

Organizations & group practices 7

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.

• Orthopaedic Associates of Wisconsin, SC Orthopaedic Surgery Physician · Pewaukee, WI · NPI 1689656951
  Medicare reassignment Care Compare group WI
• Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist · Pewaukee, WI · NPI 1801907464
  Medicare reassignment NPD PHYSICAL THERAPIST · WI
• Orthopaedic Associates of Wisconsin SC Orthopaedic Surgery Physician · Mukwonago, WI · NPI 1720433790
  Care Compare group
• Orthopaedic Associates of Wisconsin SC Orthopaedic Surgery Physician · Brookfield, WI · NPI 1952756769
  Care Compare group
• Athletic & Therapeutic Institute of Milwaukee LLC Physical Therapist · Wauwatosa, WI · NPI 1104138486
  NPD PHYSICAL THERAPIST
• Athletic &Therapeutic Institute of Naperville, LLC Physical Therapist · Joliet, IL · NPI 1598872921
  NPD (past) PHYSICAL THERAPIST
• Athletic and Therapeutic Institute of Joliet LLC Physical Therapist · Joliet, IL · NPI 1932249109
  NPD (past) PHYSICAL THERAPIST

Medicare Care Compare profile

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedic Associates of Wisconsin SC (106 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in WI

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

No

HHS exclusion list flag

The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 19, 2024.

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1407080153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 N GRANDVIEW BLVD STE 100",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725546",
            "telephone_number": "262-574-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N15W28300 Golf Rd",
            "address_purpose": "LOCATION",
            "city": "Pewaukee",
            "state": "WI",
            "postal_code": "530724800",
            "country_code": "US",
            "telephone_number": "262-303-5055",
            "fax_number": "262-303-5057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3082 Caton Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604351455",
            "country_code": "US",
            "telephone_number": "815-577-9936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERLIHY",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-11",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010782A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12772-24",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017165",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100288649",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100039803",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00931570",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Pewaukee, WI · Physical Therapist in Wisconsin