Pediatric Rehabilitation Medicine Associates,LLC

Primary specialty

Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X

License

32483020 Issued in WI

Legal business name

PEDIATRIC REHABILITATION MEDICINE ASSOCIATES,LLC

Practice address

3333 N. Mayfair Rd
Suite 103
Wauwatosa, WI 53222-3219

Phone

(262) 527-1998

Fax

(866) 562-3609

NPI assigned

Apr 14, 2011

Organization subpart

No

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

Authorized official

Name

Elizabeth Moberg-Wolff, MDNPI 1184677825

Title

Owner

Phone

(262) 527-1998

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Moberg-Wolff, MD

  • Pediatric Rehabilitation Medicine Physician
  • Wauwatosa, WI
  • NPI 1184677825
  NPD Authorized official

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675209600000",
    "number": "1629368337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18970 CAVENDISH RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530458159",
            "telephone_number": "262-527-1998",
            "fax_number": "866-562-3609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N. MAYFAIR RD",
            "address_2": "SUITE 103",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532223219",
            "telephone_number": "262-527-1998",
            "fax_number": "866-562-3609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC REHABILITATION MEDICINE ASSOCIATES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-14",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A",
        "authorized_official_last_name": "MOBERG-WOLFF",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-527-1998",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "WI",
            "license": "32483020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Garrett Payne, D.D.S.
• Bryan James Peacock, L.P.C.
• James Frank Pechloff Jr., DDS
• Dean Pecor
• Pediatric Psychology Associates LLC
• Kelsey Paige Pendleton
• Regina Penn, MS, LPC
• Joahne C Penney, LPN
• Jolanta Pentala, MD
• Amy Lynn Pepe

• Pediatric Rehabilitation Medicine Physician in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Pediatric Rehabilitation Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.