Individual provider Active NPI

Tyler Martin, PT, DPT

  • Physical Therapist
  • Neenah, WI
National Provider Identifier
1720893571
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
816 W Winneconne Ave
Neenah, WI 54956-3196
Phone
(920) 727-2000
NPI assigned
Feb 10, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2026

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 WI Primary

Addresses

Primary practice location

816 W Winneconne Ave
Neenah, WI 54956-3196

Mailing address

816 W Winneconne Ave
Neenah, WI 54956-3196

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250225000630 WI Practitioner - Physical Therapist in Private Practice 6709306434

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2105 E Enterprise Ave
Suite 113
Appleton, WI 54913-7862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy & Sports Medicine SC Physical Therapist CurrentSince Feb 19, 2025 Accepting new patients
Advanced Physical Therapy & Sports Medicine SC Physical Therapist CurrentSince Feb 19, 2025 Accepting new patients

Locations

2105 E Enterprise Ave
Ste 113
Appleton, WI 54913
Phone (920) 560-1083

2105 E Enterprise Ave
Appleton, WI 54913
Phone (920) 560-1000

2223 Lime Kiln Rd
Green Bay, WI 54311
Phone (920) 430-4770

124 Siegler St
Green Bay, WI 54303
Phone (920) 494-9661

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": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1720893571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W WINNECONNE AVE",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 W WINNECONNE AVE",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563196",
            "telephone_number": "920-727-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TYLER",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-10",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.