Diane Mary Ott, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4345-024 Issued in WI

Practice address

516 E Green Bay Ave
Saukville, WI 53080

Phone

(262) 284-9510

Fax

(262) 284-9511

NPI assigned

Apr 24, 2007

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

Other identifiers 1

Other names 1

• Ms. Diane Mary Bruer Former name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Riverside Physical Therapy & Pelvic Health, S.C.

  • Physical Therapist
  • Saukville, WI
  • NPI 1487491205
  Medicare reassignment NPD Authorized official
• Riverview Physical Therapy & Sports Medicine ,S.C.

  • Physical Therapist
  • Saukville, WI
  • NPI 1922180918
  NPD Authorized official

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1659590370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 E GREEN BAY AVE",
            "address_2": "RIVERVIEW PHYSICAL THERAPY & SPORTS MEDICINE S.C.",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "53080",
            "telephone_number": "262-284-9510",
            "fax_number": "262-284-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E GREEN BAY AVE",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "53080",
            "telephone_number": "262-284-9510",
            "fax_number": "262-284-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTT",
        "first_name": "DIANE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4345-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40377600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "BRUER",
            "middle_name": "MARY",
            "prefix": "MS.",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• George Stephen Mann III, PT
• Benjamin William Mattila, PHARMD
• Latisha Irene Metealf
• Midwest Audiology & Hearing Center Saukville LLC
• Stuart W Natale, OD
• Shelby Pupp, AUD
• Riverside Physical Therapy & Pelvic Health, S.C.
• Riverview Physical Therapy & Sports Medicine ,S.C.
• Cary Joseph Rothman, RPH
• Katelyn Sadler

• Physical Therapist in Saukville, WI
• Providers in Saukville, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; 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.