Individual provider Active NPI

Karli C Eterno, DPT

  • Physical Therapist
  • Burlington, WI
National Provider Identifier
1710510227
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14178 Issued in WI
Practice address
709 Spring Valley Rd
Burlington, WI 53105-7614
Phone
(262) 971-9300
NPI assigned
Feb 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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 14178 WI Primary

Addresses

Primary practice location

709 Spring Valley Rd
Burlington, WI 53105-7614

Mailing address

915 Bayview Ave
Twin Lakes, WI 53181-9208

Other identifiers 1

IdentifierTypeStateIssuer
100097671MedicaidWI

Other names 1

  • Karli C Dorn Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kdorn255729@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211116002534 WI Practitioner - Physical Therapist in Private Practice 0749679504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

700 N Lake Ave
Suite 102
Twin Lakes, WI 53181-9436
Phone (262) 877-2124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14178WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Nov 22, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 22, 2021 Accepting new patients

Locations

709 Spring Valley Rd
Burlington, WI 53105
Phone (262) 767-6020

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

700 N Lake Ave
Ste 102
Twin Lakes, WI 53181
Phone (262) 877-2124

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": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1710510227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 BAYVIEW AVE",
            "city": "TWIN LAKES",
            "state": "WI",
            "postal_code": "531819208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 SPRING VALLEY RD",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531057614",
            "telephone_number": "262-971-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETERNO",
        "first_name": "KARLI",
        "middle_name": "C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100097671",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdorn255729@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "700 N Lake Ave",
            "city": "Twin Lakes",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531819436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "700 N Lake Ave",
            "city": "Twin Lakes",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531819436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KARLI",
            "last_name": "DORN",
            "middle_name": "C",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.