Sean Green
Individual provider Active NPI Physical Therapist · Green Bay, WI
NPI 1649950841 · NPPES record last updated Jul 11, 2025
Key facts
- NPI
- 1649950841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 15999-24 (WI)
- Practice address
- 2223 Lime Kiln Rd
Green Bay, WI 54311-6213 - Phone
- (920) 425-7140
- NPI assigned
- Jul 21, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Physical Therapy and Sports Medicine SC
Practice addresses (Care Compare)
2223 Lime Kiln Rd
Green Bay, WI 54311-6213
Phone (920) 965-4715
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230824000371 | WI | Practitioner - Physical Therapist in Private Practice | 5597128538 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15999-24 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Physical Therapy & Sports Medicine SC | Physical Therapist | Current |
Accepting new patients |
| Advanced Physical Therapy & Sports Medicine SC | Physical Therapist | Current |
Accepting new patients |
Locations
2105 E Enterprise Ave
Ste 113
Appleton, WI 54913
Phone (920) 560-1083
2105 E Enterprise Ave
Appleton, WI 54913
Phone (920) 560-1000
2223 Lime Kiln Rd
Green Bay, WI 54311
Phone (920) 430-4770
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15999-24 | WI | Yes |
Addresses
Primary practice location
2223 Lime Kiln Rd
Green Bay, WI 54311-6213
Mailing address
2105 E Enterprise Ave Ste 113
Appleton, WI 54913-7862
Other providers in Green Bay, WI
- Alex Jonathan Green
- Carli Green
- G. Lynn Green
- Katherine A. Green
- Katie Rose Green
- Dawn Marie Greenawald
- Greenbayctd LLC
- Cameron Greene
- Justin Lee Greene
- Richard C Greene
All providers in Green Bay, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.