Individual provider Active NPI

Andrew John Nemcek, DPT

  • Physical Therapist
  • Waukesha, WI
National Provider Identifier
1649818238
Registry record updated Dec 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
209 W Main St
Waukesha, WI 53186-4603
Phone
(262) 446-9488
NPI assigned
Dec 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

209 W Main St
Waukesha, WI 53186-4603

Mailing address

21500 Clearfield Rd
Brookfield, WI 53045-3209
Phone (262) 366-1103

Other practice location 1

17280 W North Ave
Brookfield, WI 53045-4366
Phone (262) 780-0707

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200114001455 WI Practitioner - Physical Therapist in Private Practice 0446685804 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
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

209 W Main St
Waukesha, WI 53186-4603
Phone (262) 446-9488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Dec 17, 2019 Accepting new patients
Prohealth Medical Group Inc CurrentSince Dec 17, 2019 Accepting new patients

Locations

17280 W North Ave
Brookfield, WI 53045
Phone (262) 780-0707

17280 W North Ave
Ste 104
Brookfield, WI 53045
Phone (262) 780-0707

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

209 W Main St
Waukesha, WI 53186
Phone (262) 446-9488

717 W Moreland Blvd
Waukesha, WI 53188
Phone (262) 542-9100

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

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": "1576281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576281600000",
    "number": "1649818238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21500 CLEARFIELD RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530453209",
            "telephone_number": "262-366-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W MAIN ST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864603",
            "telephone_number": "262-446-9488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17280 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530454366",
            "country_code": "US",
            "telephone_number": "262-780-0707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEMCEK",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-14",
        "last_updated": "2019-12-14",
        "certification_date": "2019-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.