Individual provider Active NPI

Jeff Salsieder, DPT

  • Physical Therapist
  • Elroy, WI
National Provider Identifier
1508240300
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13124 Issued in WI
Practice address
307 Royall Ave
Heritage Manor
Elroy, WI 53929
Phone
(608) 462-8491
NPI assigned
Jul 13, 2015
Last updated
Jul 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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 13124 WI Primary

Addresses

Primary practice location

307 Royall Ave
Heritage Manor
Elroy, WI 53929

Mailing address

680 South Fourth Street
Kindred Healthcare
Louisville, KY 40202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180920000380 TX Practitioner - Physical Therapist in Private Practice 2860743424 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13124WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lawton Indian Hospital CurrentSince Jul 17, 2018 Accepting new patients
Anadarko Indian Health Center CurrentSince Jul 17, 2018 Accepting new patients

Locations

201 E Parker McKenzie Dr
Anadarko, OK 73005
Phone (405) 247-7900

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1508240300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 SOUTH FOURTH STREET",
            "address_2": "KINDRED HEALTHCARE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 ROYALL AVE",
            "address_2": "HERITAGE MANOR",
            "city": "ELROY",
            "state": "WI",
            "postal_code": "53929",
            "telephone_number": "608-462-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALSIEDER",
        "first_name": "JEFF",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elroy, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.