Brandon G Goldbeck, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5190-024 Issued in WI

Practice address

W63N541 Hanover Ave
Cedarburg, WI 53012-1917

Phone

(262) 375-2195

Fax

(262) 375-2273

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Orthopaedic Hospital of Wisconsin, LLC

  • General Acute Care Hospital
  • Glendale, WI
  • NPI 1669584983
  NPD Authorized official

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578563979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W63N541 HANOVER AVE",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530121917",
            "telephone_number": "262-375-2195",
            "fax_number": "262-375-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W63N541 HANOVER AVE",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530121917",
            "telephone_number": "262-375-2195",
            "fax_number": "262-375-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBECK",
        "first_name": "BRANDON",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5190-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40253900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Jane Gardenier, MS, LPC, CSAC, ICS
• Marlyn K Gassert
• Tiffany J Geiger, APNP
• Ghrist Orthodontics, LTD.
• Sally Ghrist, D.D.S, M.S.
• Jennifer L Goldbeck, P.T.
• Alisha Elizabeth Golec, M.S. CF-SLP
• Lenay Jennifer Graham, CD, CLD
• Jennifer Marie Hadler
• Jo Anne Hadler

• Physical Therapist in Cedarburg, WI
• Providers in Cedarburg, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.