Individual provider Active NPI

Benjamin Sorenson, DPT

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1619538972
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14765-24 Issued in WI
Practice address
1271 N 6TH St
Milwaukee, WI 53212-3360
Phone
(414) 805-3666
NPI assigned
Jun 26, 2019
Last updated
Jun 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11564 MN
Physical Therapist 225100000X 14765-24 WI Primary

Addresses

Primary practice location

1271 N 6TH St
Milwaukee, WI 53212-3360

Mailing address

1271 N 6TH St
Milwaukee, WI 53212-3360
Phone (414) 805-3666

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190724001525 WI Practitioner - Physical Therapist in Private Practice 5294061560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1271 N 6TH St
Milwaukee, WI 53212-3360
Phone (414) 978-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11564MNMDPhysical Therapist
14765-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 21, 2019 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 21, 2019 Accepting new patients
The Medical College of Wisconsin, Inc. Physical Therapist Current Accepting new patients

Locations

21700 Intertech Dr
Brookfield, WI 53045
Phone (262) 532-8300

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

1271 N 6th St
Milwaukee, WI 53212
Phone (414) 978-9037

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1619538972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1271 N 6TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123360",
            "telephone_number": "414-805-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1271 N 6TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123360",
            "telephone_number": "414-805-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11564",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14765-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.