Diane Ping
Individual provider Active NPI Physical Therapist · Fox Point, WI
NPI 1720008519 · NPPES record last updated Apr 13, 2010
Key facts
- NPI
- 1720008519
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 6908 N Santa Monica Blvd
Fox Point, WI 53217-3942 - Phone
- (414) 352-2082
- Fax
- (414) 352-5279
- NPI assigned
- Jul 21, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Freedom Physical Therapy Services SC
Practice addresses (Care Compare)
6908 N Santa Monica Blvd
Fox Point, WI 53217-3942
Phone (414) 352-2082
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120727000654 | WI | Practitioner - Physical Therapist in Private Practice | 6204092703 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freedom Physical Therapy Services SC | Physical Therapist | Current |
Accepting new patients |
Locations
17495 W Capitol Dr
Ste I
Brookfield, WI 53045
Phone (262) 790-9800
1235 Dakota Dr
Ste L
Grafton, WI 53024
Phone (262) 376-2085
6908 N Santa Monica Blvd
Milwaukee, WI 53217
Phone (414) 352-2082
111 Atkinson St
Ste 2
Mukwonago, WI 53149
Phone (262) 363-3268
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
6908 N Santa Monica Blvd
Fox Point, WI 53217-3942
Mailing address
6908 N Santa Monica Blvd
Fox Point, WI 53217-3942
Phone (414) 352-2082
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40379800 | Medicaid | WI |
Other providers in Fox Point, WI
- Pain Centers of Wisconsin - Fox Point, LLC
- Pain Centers of Wisconsin - Fox Point, LLC
- Sharyl Paley
- Philip A Parda
- Nathan T Paschke
- Rebekah K Pogwizd
- Evelyn Irene Pollock
- Evelyn Pumphrey
- Robyn Rathe
- Taylor Rickaby
All providers in Fox Point, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.