Blake Randall Van Maanen

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

15128-24 Issued in WI

Practice address

N91W15750 Falls Pkwy
Menomonee Falls, WI 53051-2301

Phone

(262) 532-1100

Fax

(262) 532-1409

NPI assigned

Jun 30, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert Andthe Medical College of Wisconsin Community Physicians IncGroup PAC ID 3678760063, 1,265 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment Care Compare group NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Physical Therapist

  NPD

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1659998284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 MARATHON AVE",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549565080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N91W15750 FALLS PKWY",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512301",
            "telephone_number": "262-532-1100",
            "fax_number": "262-532-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN MAANEN",
        "first_name": "BLAKE",
        "middle_name": "RANDALL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-30",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15128-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Christine Utley, PA
• Gary Valestin, M.D.
• Valuecare LLC
• Aisha Van Bommel
• Rebecca Van Grinsven, COTA
• Scott D. Van Steen, M.D.
• Delaney Van Treeck, DPT, CLT
• Gregory N Van Winkle, M.D.
• Karen Therese Vandervort, LPC-IT
• Chinou Vang, MD

• Physical Therapist in Menomonee Falls, WI
• Providers in Menomonee Falls, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; 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.