Active NPI
Sarah Tomecek, DPT
- Physical Therapist
- Lake Geneva, WI
National Provider Identifier
1679169007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 16163
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100221803 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16163 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 070.025479 | IL | MD | Physical Therapist |
| LPT-31514 | AZ | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Health Care Southern Lakes, Inc. | Past | Accepting new patients | |
| Jodi Gilray PT PLLC | Physical Therapist | Past | 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.
-
- General Acute Care Hospital
- Kenosha, WI
- NPI 1225156888
-
- Rehabilitation Clinic/Center
- Prescott Valley, AZ
- NPI 1689097651
Physical Therapist
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.