Active NPI
Derek Blue, PT
- Physical Therapist
- West Bend, WI
National Provider Identifier
1538034624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- CP044643T
- Practice address
- 2130 Continental Dr
West Bend, WI 53095-7904 - Phone
- (877) 407-3422
- Fax
- (877) 407-4329
- NPI assigned
- Oct 8, 2025
- Sex
- Male
- 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 | CP044643T | WI | Primary |
Addresses
Primary practice location
2130 Continental Dr
West Bend, WI 53095-7904
Mailing address
7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251020001621 | WI | Practitioner - Physical Therapist in Private Practice | 8729576053 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fox Rehabilitation Services Wi LLC
Practice addresses (Care Compare)
2130 Continental Dr
West Bend, WI 53095-7904
Phone (262) 338-0092
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP044643T | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehabilitation Services Wi LLC | Physical Therapist | Current | Accepting new patients |
Locations
7 Carnegie Plz
Cherry Hill, NJ 08003
Organizations & group practices 1
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.
-
- Physical Therapist
- Milwaukee, WI
- NPI 1518483973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759881600000",
"number": "1538034624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 CARNEGIE PLZ",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080031000",
"telephone_number": "877-407-3422",
"fax_number": "877-407-4329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2130 CONTINENTAL DR",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530957904",
"telephone_number": "877-407-3422",
"fax_number": "877-407-4329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUE",
"first_name": "DEREK",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-10-08",
"last_updated": "2025-10-08",
"certification_date": "2025-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "CP044643T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.