Individual provider Active NPI

Brittany Kostichka

  • Occupational Therapist
  • Manitowoc, WI
National Provider Identifier
1568328144
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
9076-26 Issued in WI
Practice address
1650 S 41St St
Manitowoc, WI 54220-7316
Phone
(920) 320-3100
NPI assigned
Dec 29, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 9076-26 WI Primary

Addresses

Primary practice location

1650 S 41St St
Manitowoc, WI 54220-7316

Mailing address

1650 S 41St St
Manitowoc, WI 54220-7316

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

N74W12501 Leatherwood CT
Menomonee Falls, WI 53051

N74W12501 Leatherwood CT
Menomonee Falls, WI 53051-4490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9076-26WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1568328144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 S 41ST ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542207316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 S 41ST ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542207316",
            "telephone_number": "920-320-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTICHKA",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "9076-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.