Active NPI
Todd Waterkotte, DPT
- Physical Therapist
- Mesa, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- LPT-012133
- Practice address
- 8427 E Baseline Rd
Mesa, AZ 85209-4378 - Phone
- (480) 306-6627
- Fax
- (480) 306-6696
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070-010262 | IL | |
| Physical Therapist | 225100000X | LPT-012133 | AZ | Primary |
Addresses
Primary practice location
8427 E Baseline Rd
Mesa, AZ 85209-4378
Mailing address
6512 E Sharon Dr Ste 100
Scottsdale, AZ 85254-3948
Phone (217) 617-1895
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14202 N Scottsdale Rd
Suite 169
Scottsdale, AZ 85254-4081
Phone (480) 265-2122
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPT-012133 | AZ | MD | Physical Therapist |
| 070-010262 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Modern Sports Medicine LLC | Current | Accepting new patients | |
| Brian F. Gruber, M.D., LTD | Physical Therapist | Current | Accepting new patients |
| Modern Sports Medicine LLC | Physical Therapist | Current | Accepting new patients |
| Advance PT Therapy of Hannibal LLC | Physical Therapist | Past | Accepting new patients |
| Bloom Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
| Neurosurgical Associates, LTD | Physical Therapist | Past | Accepting new patients |
Locations
5590 W Chandler Blvd
Ste 4
Chandler, AZ 85226
Phone (480) 786-4969
8427 E Baseline Rd
Ste 101
Mesa, AZ 85209
Phone (480) 357-6500
8427 E Baseline Rd
Mesa, AZ 85209
20940 N Tatum Blvd
Ste B290
Phoenix, AZ 85050
Phone (602) 734-1826
17300 N Perimeter Dr
Ste 150
Scottsdale, AZ 85255
Phone (602) 734-1826
10450 E Riggs Rd
Ste 104
Sun Lakes, AZ 85248
Phone (612) 888-5224
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.
-
- Physical Therapist
- Anthem, AZ
- NPI 1821109356
-
dba Integrated Orthopedics of Arizona
- Sports Medicine (Orthopaedic Surgery) Physician
- Scottsdale, AZ
- NPI 1700284791
Physical Therapist
-
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Sun Lakes, AZ
- NPI 1285295089
Physical Therapist
-
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Tucson, AZ
- NPI 1609662709
-
- Physical Therapist
- Mesa, AZ
- NPI 1003359225
-
dba Barrow Brain and Spine
- Neurological Surgery Physician
- Phoenix, AZ
- NPI 1043202484
Physical Therapist
-
dba Advance Physical Therapy & Sports Medicine of Hannibal, LLC
- Physical Therapist
- Hannibal, MO
- NPI 1588678403
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1427064575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6512 E SHARON DR STE 100",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852543948",
"telephone_number": "217-617-1895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8427 E BASELINE RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852094378",
"telephone_number": "480-306-6627",
"fax_number": "480-306-6696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERKOTTE",
"first_name": "TODD",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-010262",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "LPT-012133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.