Individual provider Active NPI

Paige Hentrich, PT, DPT, ATC

  • Physical Therapist
  • Platteville, WI
National Provider Identifier
1467059873
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15183 Issued in WI
Practice address
1240 Big Jack Rd
Platteville, WI 53818-8902
Phone
(608) 348-2844
Fax
(608) 342-5600
NPI assigned
Oct 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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 15183 WI Primary

Addresses

Primary practice location

1240 Big Jack Rd
Platteville, WI 53818-8902

Mailing address

1240 Big Jack Rd
Platteville, WI 53818-8902
Phone (608) 348-2844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240502001907 WI Practitioner - Physical Therapist in Private Practice 8921448333 Reassigns benefits to 1 organization
I20240509000250 IA Practitioner - Physical Therapist in Private Practice 8921448333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates Clinic P CGroup PAC ID 3870491228, 228 clinicians

Practice addresses (Care Compare)

1240 Big Jack Rd
Platteville, WI 53818-8902
Phone (608) 348-6266

1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15183WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates Clinic P C CurrentSince Apr 8, 2024 Accepting new patients

Locations

1500 Associates Dr
Dubuque, IA 52002
Phone (563) 584-4100

1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455

1240 Big Jack Rd
Platteville, WI 53818
Phone (608) 348-2844

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1467059873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 BIG JACK RD",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538188902",
            "telephone_number": "608-348-2844",
            "fax_number": "608-342-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 BIG JACK RD",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538188902",
            "telephone_number": "608-348-2844",
            "fax_number": "608-342-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTRICH",
        "first_name": "PAIGE",
        "credential": "PT, DPT,  ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2024-04-16",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15183",
            "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 Apr 16, 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.