Individual provider Active NPI

Michael Leiterman

  • Physical Therapist
  • Wausau, WI
National Provider Identifier
1528402385
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12080-24 Issued in WI
Practice address
333 Pine Ridge Blvd
Wausau, WI 54401-4120
Phone
(715) 847-2826
NPI assigned
Apr 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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 12080-24 WI Primary

Addresses

Primary practice location

333 Pine Ridge Blvd
Wausau, WI 54401-4120

Mailing address

2080 Windsor CT Apt 2
Plover, WI 54467-4153
Phone (715) 304-9182

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131224000233 WI Practitioner - Physical Therapist in Private Practice 8729215553 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Medical Group, Inc. CurrentSince Dec 1, 2013 Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Dec 1, 2013 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Jul 26, 2024 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Jul 26, 2024 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

209 Prentice St N
Stevens Point, WI 54481
Phone (715) 344-4611

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

2957 Church St
Stevens Point, WI 54481
Phone (715) 345-1447

190 Grand Seasons Dr
Waupaca, WI 54981
Phone (715) 258-3401

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

Organizations & group practices 6

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": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1528402385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 WINDSOR CT APT 2",
            "city": "PLOVER",
            "state": "WI",
            "postal_code": "544674153",
            "telephone_number": "715-304-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014120",
            "telephone_number": "715-847-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITERMAN",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12080-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; 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.