Individual provider Active NPI

Susan Ruiz Frankel, PTA

  • Physical Therapy Assistant
  • Pleasant Prairie, WI
National Provider Identifier
1508033168
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
755-019 Issued in WI
Practice address
10330 Prairie Ridge Blvd
Pleasant Prairie, WI 53158-1947
Phone
(262) 612-2856
Fax
(262) 612-2893
NPI assigned
May 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 755-019 WI Primary

Addresses

Primary practice location

10330 Prairie Ridge Blvd
Pleasant Prairie, WI 53158-1947

Mailing address

10330 Prairie Ridge Blvd
Pleasant Prairie, WI 53158-1947
Phone (262) 612-2856

Other identifiers 1

IdentifierTypeStateIssuer
40355900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
755-019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1508033168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 PRAIRIE RIDGE BLVD",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581947",
            "telephone_number": "262-612-2856",
            "fax_number": "262-612-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 PRAIRIE RIDGE BLVD",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581947",
            "telephone_number": "262-612-2856",
            "fax_number": "262-612-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANKEL",
        "first_name": "SUSAN",
        "middle_name": "RUIZ",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "755-019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40355900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.