Brooklyn Sandow, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

930 Elen Anenue
Amery, WI 54001-1448

Phone

(715) 268-5103

Fax

(715) 263-5101

NPI assigned

Jun 10, 2024

Last updated

Jun 10, 2024By the provider in NPPES

Sex

Female

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clear Lake Physical Therapy and Rehab Specialists LLCGroup PAC ID 0749327526, 4 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clear Lake Physical Therapy and Rehab Specialists LLC

  • Physical Therapist
  • Clear Lake, WI
  • NPI 1083845754
  Medicare reassignment Care Compare group NPD
• Clear Lake Physical Therapy and Rehab Specialists LLC

  • Physical Therapy Clinic/Center
  • Prairie Farm, WI
  • NPI 1083328785
  NPD

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1689416711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "CLEAR LAKE",
            "state": "WI",
            "postal_code": "540058905",
            "telephone_number": "715-263-4103",
            "fax_number": "715-263-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 ELEN ANENUE",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011448",
            "telephone_number": "715-268-5103",
            "fax_number": "715-263-5101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "417 3rd Avenue",
            "address_purpose": "LOCATION",
            "city": "Clear Lake",
            "state": "WI",
            "postal_code": "540058905",
            "country_code": "US",
            "telephone_number": "715-263-4103",
            "fax_number": "715-263-4110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "224 River Ave S",
            "address_purpose": "LOCATION",
            "city": "Prairie Farm",
            "state": "WI",
            "postal_code": "547629786",
            "country_code": "US",
            "telephone_number": "715-455-4103",
            "fax_number": "715-455-4106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Becker St",
            "address_purpose": "LOCATION",
            "city": "Turtle Lake",
            "state": "WI",
            "postal_code": "548899205",
            "country_code": "US",
            "telephone_number": "159-864-1037",
            "fax_number": "715-986-4128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOW",
        "first_name": "BROOKLYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Amery, WI
• Providers in Amery, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.