Active NPI
Andrew Steven Krikelas
- Physical Therapy Assistant
- West Allis, WI
National Provider Identifier
1649097130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2669-19
- Practice address
- 2330 S 54TH St
West Allis, WI 53219-2290 - Phone
- (414) 615-7100
- NPI assigned
- Sep 25, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A4778 | MD | |
| Physical Therapy Assistant | 225200000X | 2669-19 | WI | Primary |
Addresses
Primary practice location
2330 S 54TH St
West Allis, WI 53219-2290
Mailing address
5454 Fargo Ave
Skokie, IL 60077-3210
Phone (847) 834-4923
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A4778 | MD | MD | Physical Therapy Assistant |
| 2669-19 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1649097130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5454 FARGO AVE",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600773210",
"telephone_number": "847-834-4923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2330 S 54TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532192290",
"telephone_number": "414-615-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRIKELAS",
"first_name": "ANDREW",
"middle_name": "STEVEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-25",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A4778",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "2669-19",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.