Individual provider Active NPI

Tricia Rose Serres, DPT

  • Physical Therapist
  • Platteville, WI
National Provider Identifier
1417593294
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16679-24 Issued in WI
Practice address
1400 Eastside Rd
Platteville, WI 53818-9800
Phone
(608) 348-2331
NPI assigned
Nov 26, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 11

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.

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Health Center Inc 110 clinicians

Practice addresses (Care Compare)

1400 Eastside Rd
Platteville, WI 53818-9800
Phone 60834823312263

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240705002444 WI Practitioner - Physical Therapist in Private Practice 2163844176 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16679-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Health Center, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Southwest Health Center, Inc Current Accepting new patients
Southwest Health Center, Inc. Physical Therapist CurrentSince Jun 1, 2024 Accepting new patients
Statera LLC Past Accepting new patients
Sport & Spine Therapy of Marin Inc Physical Therapist PastSince Jun 8, 2020 Accepting new patients

Locations

1400 Eastside Rd
Platteville, WI 53818
Phone (608) 342-4712

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X
Physical Therapist 225100000X 16679-24 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

1400 Eastside Rd
Platteville, WI 53818-9800

Mailing address

5389 Park PL
Asbury, IA 52002-2457
Phone (608) 732-6469

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 10, 2024.

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1417593294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5389 PARK PL",
            "city": "ASBURY",
            "state": "IA",
            "postal_code": "520022457",
            "telephone_number": "608-732-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EASTSIDE RD",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538189800",
            "telephone_number": "608-348-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRES",
        "first_name": "TRICIA",
        "middle_name": "ROSE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16679-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Platteville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.