Individual provider Active NPI

John A. Levene, DPT

  • Physical Therapist
  • Pewaukee, WI
National Provider Identifier
1619097326
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2720-024 Issued in WI
Practice address
2835 N Grandview Blvd Ste 100
Pewaukee, WI 53072-5546
Phone
(262) 574-1100
Fax
(262) 574-5193
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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 2720-024 WI Primary

Addresses

Primary practice location

2835 N Grandview Blvd Ste 100
Pewaukee, WI 53072-5546

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

2455 N 124th St
Brookfield, WI 53005-4630
Phone (615) 778-4066

Other practice location 2

N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055

Other identifiers 1

IdentifierTypeStateIssuer
100253078MedicaidWI

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2720-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist CurrentSince Feb 3, 2024 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist CurrentSince Feb 3, 2024 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist Current Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

S74W16867 Janesville Rd
Muskego, WI 53150
Phone (262) 971-4200

2835 N Grandview Blvd
Ste 100
Pewaukee, WI 53072
Phone (262) 574-1100

Organizations & group practices 3

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1619097326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 N GRANDVIEW BLVD STE 100",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725546",
            "telephone_number": "262-574-1100",
            "fax_number": "262-574-5193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2455 N 124th St",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530054630",
            "country_code": "US",
            "telephone_number": "615-778-4066",
            "fax_number": "615-778-9114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N15W28300 Golf Rd",
            "address_purpose": "LOCATION",
            "city": "Pewaukee",
            "state": "WI",
            "postal_code": "530724800",
            "country_code": "US",
            "telephone_number": "262-303-5055",
            "fax_number": "262-303-5057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVENE",
        "first_name": "JOHN",
        "middle_name": "A.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2720-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100253078",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.