Peter Eidsmoe, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14535 Issued in WI

Practice address

2915 W Layton Ave
Greenfield, WI 53221-2626

Phone

(414) 282-7810

Fax

(414) 282-9120

NPI assigned

Mar 5, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PT Plus Management CorpGroup PAC ID 9830255918, 14 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.

• PT Plus Management Corp

  • Physical Therapist
  • Mt Pleasant, WI
  • NPI 1477798338
  Medicare reassignment Care Compare group NPD
• Whole Path Psychotherapy LLC

  • Clinical Social Worker
  • Milwaukee, WI
  • NPI 1356061485
  NPD (past)

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1689132045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 S GREEN BAY RD STE 200",
            "city": "MT PLEASANT",
            "state": "WI",
            "postal_code": "534064468",
            "telephone_number": "262-321-0240",
            "fax_number": "262-321-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212626",
            "telephone_number": "414-282-7810",
            "fax_number": "414-282-9120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Pilgrim Pkwy Ste L8",
            "address_purpose": "LOCATION",
            "city": "Elm Grove",
            "state": "WI",
            "postal_code": "531222064",
            "country_code": "US",
            "telephone_number": "262-796-2850",
            "fax_number": "262-796-2851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 E Washington St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Slinger",
            "state": "WI",
            "postal_code": "530869650",
            "country_code": "US",
            "telephone_number": "262-395-9262",
            "fax_number": "262-321-0242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "122 Green Bay Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Thiensville",
            "state": "WI",
            "postal_code": "530921624",
            "country_code": "US",
            "telephone_number": "262-395-9262",
            "fax_number": "262-321-0242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3073 S Chase Ave Ste 630",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532072668",
            "country_code": "US",
            "telephone_number": "414-292-3275",
            "fax_number": "414-292-3298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "241 N Broadway Ste 403",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532025819",
            "country_code": "US",
            "telephone_number": "414-446-9291",
            "fax_number": "414-446-8618",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1532 S Green Bay Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "WI",
            "postal_code": "534064468",
            "country_code": "US",
            "telephone_number": "262-321-0240",
            "fax_number": "262-321-0242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EIDSMOE",
        "first_name": "PETER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dva Renal Healthcare Inc
• Eagle P-T
• Lindsay M Eaton
• Gina Elaine Edson, APNP
• Sonhui Edwards
• Elite Medical Supply LLC
• Elizabeth Polacheck MD SC
• Mazin Ellias, M.D.
• Suhaib Kamal Elobaid, M.D
• Emvora

• Physical Therapist in Greenfield, WI
• Providers in Greenfield, 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 25, 2019; 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.