Active NPI
Samantha K Keeser
- Physical Therapist
- Waukesha, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 16706-24
- Practice address
- 717 W Moreland Blvd
Waukesha, WI 53188-2432 - Phone
- (262) 696-5265
- NPI assigned
- May 17, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 16706-24 | WI | Primary |
Addresses
Primary practice location
717 W Moreland Blvd
Waukesha, WI 53188-2432
Mailing address
717 W Moreland Blvd
Waukesha, WI 53188-2432
Phone (262) 696-5265
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
717 W Moreland Blvd
Waukesha, WI 53188-2432
Phone (262) 542-9100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16706-24 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc | Current | Accepting new patients | |
| Prohealth Medical Group Inc. | Current | Accepting new patients |
Locations
240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900
725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011
N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093
N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030
717 W Moreland Blvd
Waukesha, WI 53188
Phone (262) 542-9100
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Waukesha, WI
- NPI 1356322440
-
- Family Medicine Physician
- Waukesha, WI
- NPI 1720371719
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1467201723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 W MORELAND BLVD",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531882432",
"telephone_number": "262-696-5265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 W MORELAND BLVD",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531882432",
"telephone_number": "262-696-5265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEESER",
"first_name": "SAMANTHA",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-17",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "16706-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waukesha, WI
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.