Individual provider Active NPI

Brianna Depietro, DPT

  • Physical Therapist
  • Lake Geneva, WI
National Provider Identifier
1538059233
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17383-24 Issued in WI
Practice address
N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone
(262) 245-0535
NPI assigned
Jul 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physical Therapist 2251N0400X 17383-24 WI
Orthopedic Physical Therapist 2251X0800X 17383-24 WI
Physical Therapist 225100000X 17383-24 WI Primary
Geriatric Physical Therapist 2251G0304X 17383-24 WI

Addresses

Primary practice location

N2950 State Road 67
Lake Geneva, WI 53147-2655

Mailing address

555 W Kinzie St # E0711
Chicago, IL 60654-5727
Phone (262) 745-5164

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250826003604 WI Practitioner - Physical Therapist in Private Practice 2163922857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

N2846 State Rd
Suite 67
Williams Bay, WI 53191-3771
Phone (262) 245-5608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17383-24WIMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Aug 1, 2025 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Mercy Health System Corporation CurrentSince Aug 1, 2025 Accepting new patients
Mercy Health System Corporation Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

350 Peller Rd
Lake Geneva, WI 53147
Phone (262) 245-0221

N2846 State Road 67
Williams Bay, WI 53191
Phone (262) 245-5608

Organizations & group practices 4

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": "1751846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1538059233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W KINZIE ST # E0711",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545727",
            "telephone_number": "262-745-5164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N2950 STATE ROAD 67",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472655",
            "telephone_number": "262-245-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPIETRO",
        "first_name": "BRIANNA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "WI",
            "license": "17383-24",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WI",
            "license": "17383-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "17383-24",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "WI",
            "license": "17383-24",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.

Verify at the official NPI Registry.