Individual provider Active NPI

Diana F Millspaugh, DPT

  • Physical Therapist
  • New Berlin, WI
National Provider Identifier
1649582545
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
042668 Issued in NY
Practice address
15312 W Beloit Rd
New Berlin, WI 53151-7447
Phone
(262) 641-5771
NPI assigned
Jul 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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 WI
Physical Therapist 225100000X 042668 NY Primary

Addresses

Primary practice location

15312 W Beloit Rd
New Berlin, WI 53151-7447

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

1450 Western Ave Ste 101
Albany, NY 12203-3539
Phone (518) 525-5588

Other practice location 2

1270 Belmont Ave
Schenectady, NY 12308-2104
Phone (518) 382-4530

Other practice location 3

75 Vandenburgh Ave
Troy, NY 12180-6059
Phone (518) 270-3041

Other practice location 4

115 Saratoga Rd Ste 100
Glenville, NY 12302-4210
Phone (518) 386-3579

Other identifiers 1

IdentifierTypeStateIssuer
1649582545MedicaidWI

Other names 1

  • Diana F Mitsche Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211227000870 NY Practitioner - Physical Therapist in Private Practice 2163610569 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnyview Hospital and Rehabilitation Center Physical Therapist CurrentSince Sep 18, 2021 Accepting new patients
Sunnyview Hospital and Rehabilitation Center Physical Therapist Past Accepting new patients

Locations

1450 Western Ave
Ste 101
Albany, NY 12203
Phone (518) 525-5588

115 Saratoga Rd
Ste 100
Glenville, NY 12302
Phone (518) 386-3579

1270 Belmont Ave
Schenectady, NY 12308
Phone (518) 382-4500

75 Vandenburgh Ave
Troy, NY 12180
Phone (518) 270-3041

Organizations & group practices 2

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1649582545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15312 W BELOIT RD",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531517447",
            "telephone_number": "262-641-5771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Western Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122033539",
            "country_code": "US",
            "telephone_number": "518-525-5588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1270 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123082104",
            "country_code": "US",
            "telephone_number": "518-382-4530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Vandenburgh Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121806059",
            "country_code": "US",
            "telephone_number": "518-270-3041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Saratoga Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Glenville",
            "state": "NY",
            "postal_code": "123024210",
            "country_code": "US",
            "telephone_number": "518-386-3579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLSPAUGH",
        "first_name": "DIANA",
        "middle_name": "F",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649582545",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1270 Belmont Ave",
            "city": "Schenectady",
            "state": "NY",
            "country_code": "US",
            "postal_code": "123082104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "MITSCHE",
            "middle_name": "F",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.