Individual provider Active NPI

Stuart Midthun Mitchell, P.T.

  • Physical Therapist
  • Dodgeville, WI
National Provider Identifier
1730134958
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12873-24 Issued in WI
Practice address
800 Compassion Way
Dodgeville, WI 53533-1956
Phone
(608) 930-8000
NPI assigned
May 24, 2006
Sex
Male
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00008483 WA
Physical Therapist 225100000X 12873-24 WI Primary

Addresses

Primary practice location

800 Compassion Way
Dodgeville, WI 53533-1956

Mailing address

800 Compassion Way
Dodgeville, WI 53533-0800
Phone (608) 930-8000

Other identifiers 4

IdentifierTypeStateIssuer
810588134-01OtherWAKPS HEALTH PLANS
7483242OtherWAAETNA/LEXINGTON, KY
9337MIOtherWAREGENCE BLUE SHIELD
0163023OtherWADEPT OF LABOR & INDUSTRIE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150402000861 WI Practitioner - Physical Therapist in Private Practice 8022021294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Washington University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upland Hills Health IncGroup PAC ID 3072415553, 97 clinicians

Practice addresses (Care Compare)

1809 Springdale St
Mount Horeb, WI 53572-2480
Phone (608) 437-8033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00008483WAMDPhysical Therapist
12873-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Upland Hills Health, Inc. CurrentSince Apr 26, 2017 Accepting new patients
Upland Hills Health Inc Current Accepting new patients
Upland Hills Health, Inc CurrentSince Apr 26, 2017 Accepting new patients

Locations

800 Compassion Way
Dodgeville, WI 53533
Phone (608) 930-7200

1809 Springdale St
Mount Horeb, WI 53572
Phone (608) 437-8033

1809 Springdale St
Ste 101
Mount Horeb, WI 53572

Organizations & group practices 4

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730134958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 COMPASSION WAY",
            "city": "DODGEVILLE",
            "state": "WI",
            "postal_code": "535330800",
            "telephone_number": "608-930-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 COMPASSION WAY",
            "city": "DODGEVILLE",
            "state": "WI",
            "postal_code": "535331956",
            "telephone_number": "608-930-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "STUART",
        "middle_name": "MIDTHUN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008483",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12873-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KPS HEALTH PLANS",
            "identifier": "810588134-01",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/LEXINGTON, KY",
            "identifier": "7483242",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "9337MI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRIE",
            "identifier": "0163023",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodgeville, 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.