Peter A Sytsma, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

864024 Issued in WI

Practice address

3010 Highway 141
Pound, WI 54161

Phone

(920) 897-4799

Fax

(920) 897-4128

NPI assigned

Mar 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pound PT Clinic LLC

  • Physical Therapist
  • Pound, WI
  • NPI 1881771632
  NPD Authorized official

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1497872790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11",
            "address_2": "3010 HIGHWAY 141",
            "city": "POUND",
            "state": "WI",
            "postal_code": "54161",
            "telephone_number": "920-897-4799",
            "fax_number": "920-897-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 HIGHWAY 141",
            "city": "POUND",
            "state": "WI",
            "postal_code": "54161",
            "telephone_number": "920-897-4799",
            "fax_number": "920-897-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYTSMA",
        "first_name": "PETER",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "864024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40133900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian R Osterberg, D.C.
• Pound Community Medical Clinic S.C.
• Pound PT Clinic LLC
• Jessica Riedy
• Allison Mary Rutten
• Town of Brazeau

• All providers in Pound, WI
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.