Individual provider Active NPI

Mark Brauweiler, DPT

  • Physical Therapist
  • Tipton, IA
National Provider Identifier
1669831236
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
120 E 5TH St
Tipton, IA 52772-1731
Phone
(563) 886-3421
Fax
(563) 886-2083
NPI assigned
Feb 11, 2016
Last updated
Feb 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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 NU Primary

Addresses

Primary practice location

120 E 5TH St
Tipton, IA 52772-1731

Mailing address

PO Box 860143
Minneapolis, MN 55486-0143
Phone (319) 338-5700

Other identifiers 1

IdentifierTypeStateIssuer
06-65463MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220804001741 IL Practitioner - Physical Therapist in Private Practice 9830571025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evolve Physical Therapy IncGroup PAC ID 6901289875, 6 clinicians

Practice addresses (Care Compare)

3600 Thayer CT
Suite 500
Aurora, IL 60504-6700
Phone (630) 453-4052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Physical Therapy Inc Physical Therapist CurrentSince Mar 23, 2023 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Jun 21, 2022 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Jun 21, 2022 Accepting new patients

Locations

3600 Thayer Ct
Ste 500
Aurora, IL 60504
Phone (630) 453-4052

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1669831236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860143",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860143",
            "telephone_number": "319-338-5700",
            "fax_number": "319-338-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 5TH ST",
            "city": "TIPTON",
            "state": "IA",
            "postal_code": "527721731",
            "telephone_number": "563-886-3421",
            "fax_number": "563-886-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUWEILER",
        "first_name": "MARK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06-65463",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tipton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.