Individual provider Active NPI

Susana Arciga, PT

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1730128497
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5053024 Issued in WI
Practice address
604 N 16TH St
Room 215
Milwaukee, WI 53233-2117
Phone
(414) 288-1400
Fax
(414) 288-6079
NPI assigned
Jun 6, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 5053024 WI Primary

Addresses

Primary practice location

604 N 16TH St
Room 215
Milwaukee, WI 53233-2117

Mailing address

604 N 16TH St
Room 215
Milwaukee, WI 53233-2117
Phone (414) 288-1400

Other identifiers 1

IdentifierTypeStateIssuer
40445400MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040717000176 WI Practitioner - Physical Therapist in Private Practice 3971582420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marquette UniversityGroup PAC ID 0648221028, 15 clinicians

Practice addresses (Care Compare)

604 N 16TH St
RM 215
Milwaukee, WI 53233-2117
Phone (414) 288-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5053024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marquette University Physical Therapist CurrentSince Jun 1, 2017 Accepting new patients
Marquette University CurrentSince Jun 1, 2017 Accepting new patients
Kerk Physical Therapy Specialists SC Physical Therapist Past Accepting new patients
Marquette University PastSince Jan 26, 2022 Accepting new patients
Kerk Physical Therapy Specialists SC Physical Therapist PastSince Dec 24, 2023 Accepting new patients

Locations

604 N 16th St
Milwaukee, WI 53233
Phone (414) 288-1400

604 N 16th St
#215
Milwaukee, WI 53233
Phone (414) 288-1400

604 N 16th St
Rm 215
Milwaukee, WI 53233
Phone (414) 288-1400

604 N 16th St
Ste 215
Milwaukee, WI 53233

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730128497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N 16TH ST",
            "address_2": "ROOM 215",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332117",
            "telephone_number": "414-288-1400",
            "fax_number": "414-288-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N 16TH ST",
            "address_2": "ROOM 215",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332117",
            "telephone_number": "414-288-1400",
            "fax_number": "414-288-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCIGA",
        "first_name": "SUSANA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5053024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40445400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.