Individual provider Active NPI

Pamela Fuellemann, P.T.

  • Physical Therapist
  • Brookfield, WI
National Provider Identifier
1679937866
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3603 Issued in WI
Practice address
19525 W North Ave
Brookfield, WI 53045-4107
Phone
(262) 780-3813
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 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 3603 WI Primary

Addresses

Primary practice location

19525 W North Ave
Brookfield, WI 53045-4107

Mailing address

19525 W North Ave
Brookfield, WI 53045-4107
Phone (262) 780-3813

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240705002411 WI Practitioner - Physical Therapist in Private Practice 9335683937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services Wi LLCGroup PAC ID 1658647581, 144 clinicians

Practice addresses (Care Compare)

2130 Continental Dr
West Bend, WI 53095-7904
Phone (262) 338-0092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Wi LLC Physical Therapist CurrentSince Jun 1, 2024 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 1

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": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1679937866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19525 W NORTH AVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454107",
            "telephone_number": "262-780-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19525 W NORTH AVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454107",
            "telephone_number": "262-780-3813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUELLEMANN",
        "first_name": "PAMELA",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

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