Suzanne Balistreri-Roden, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2698-024 Issued in WI

Practice address

902 S Wells St
Lake Geneva, WI 53147-2422

Phone

(262) 249-1915

Fax

(262) 249-1397

NPI assigned

Dec 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

• Balistreri & Associates Physical Therapy

  • Physical Therapist
  • Lake Geneva, WI
  • NPI 1689779902
  NPD (past) Authorized official

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1639234297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1787 KNOB RD",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531058603",
            "telephone_number": "262-942-0163",
            "fax_number": "262-948-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S WELLS ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472422",
            "telephone_number": "262-249-1915",
            "fax_number": "262-249-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALISTRERI-RODEN",
        "first_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2698-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Frank Bacchus, M.D.
• Katrina Badeau, LMFT
• Sara Bader, ATC, LAT
• John Ellsworth Baldwin, RPH
• Balistreri & Associates Physical Therapy
• Anshul B. Bamrolia, MD
• Matthew Banas
• Melisa Barber
• Sally Bardin, LPC
• Ellen Grace Barnstable, MD

• Physical Therapist in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.