Individual provider Active NPI

Sarah Tomecek, DPT

  • Physical Therapist
  • Lake Geneva, WI
National Provider Identifier
1679169007
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16163 Issued in WI
Practice address
700 Geneva Pkwy N Ste a
Lake Geneva, WI 53147-4594
Phone
(262) 249-3500
NPI assigned
Dec 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X LPT-31514 AZ
Physical Therapist 225100000X 070.025479 IL
Physical Therapist 225100000X 16163 WI Primary

Addresses

Primary practice location

700 Geneva Pkwy N Ste a
Lake Geneva, WI 53147-4594

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (262) 249-3500

Other practice location 1

6550 E 2nd St Ste B
Prescott Valley, AZ 86314-3523
Phone (928) 771-9327

Other identifiers 1

IdentifierTypeStateIssuer
100221803MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16163WIMDAddiction (Substance Use Disorder) Counselor
070.025479ILMDPhysical Therapist
LPT-31514AZMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Health Care Southern Lakes, Inc. PastSince May 28, 2023 Accepting new patients
Jodi Gilray PT PLLC Physical Therapist PastSince Dec 1, 2020 Accepting new patients

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": "1608422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1679169007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "262-249-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 GENEVA PKWY N STE A",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474594",
            "telephone_number": "262-249-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6550 E 2nd St Ste B",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863143523",
            "country_code": "US",
            "telephone_number": "928-771-9327",
            "fax_number": "928-771-9519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMECEK",
        "first_name": "SARAH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-20",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AZ",
            "license": "LPT-31514",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.025479",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100221803",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.