Individual provider Active NPI

William G Boissonnault

  • Physical Therapist
  • Madison, WI
National Provider Identifier
1417978073
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1830-024 Issued in WI
Practice address
600 Highland Ave
Compliance Mail Code-2433
Madison, WI 53792-0001
Phone
(608) 662-0817
NPI assigned
Jul 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1830-024 WI Primary

Addresses

Primary practice location

600 Highland Ave
Compliance Mail Code-2433
Madison, WI 53792-0001

Mailing address

600 Highland Ave
Compliance Mail Code-2433
Madison, WI 53792-0001

Other identifiers 1

IdentifierTypeStateIssuer
1830-024OtherWIPT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250630003579 WI Practitioner - Physical Therapist in Private Practice 5294248563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health in Motion, LLCGroup PAC ID 1153311972, 26 clinicians

Practice addresses (Care Compare)

720 Ackley St
Antigo, WI 54409-2405
Phone (715) 623-2292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1830-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Health in Motion, LLC Physical Therapist CurrentSince Jun 2, 2025 Accepting new patients

Locations

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

720 Ackley St
Antigo, WI 54409
Phone (715) 623-2292

586 Shepard St
Rhinelander, WI 54501
Phone (715) 365-5256

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417978073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "address_2": "COMPLIANCE MAIL CODE-2433",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "address_2": "COMPLIANCE MAIL CODE-2433",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-662-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOISSONNAULT",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "1830-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT",
            "identifier": "1830-024",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.