Individual provider Active NPI

Tracy M Ferguson, PT

  • Physical Therapist
  • Muskego, WI
National Provider Identifier
1740325984
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9904 Issued in WI
Practice address
S74W16775 Janesville Rd
#6
Muskego, WI 53150-7742
Phone
(414) 422-2191
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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 9904 WI Primary

Addresses

Primary practice location

S74W16775 Janesville Rd
#6
Muskego, WI 53150-7742

Mailing address

S74W16775 Janesville Rd
#6
Muskego, WI 53150-7742
Phone (414) 422-2191

Other identifiers 1

IdentifierTypeStateIssuer
40401300MedicaidWI

Other names 1

  • Tracy M Heinz Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tferguson42147@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
I20040211000086 WI Practitioner - Physical Therapist in Private Practice 2961396940 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Lakeshore Medical Clinic, LLC Physical Therapist Past Accepting new patients

Locations

1001 Service Rd
Kiel, WI 53042
Phone (920) 894-2636

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

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

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

S74W16775 Janesville Rd
#6
Muskego, WI 53150
Phone (414) 422-2191

1813 Ashland Ave
Sheboygan, WI 53081
Phone (920) 458-4010

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Interoperability endpoints

  • Direct secure messaging: tferguson42147@direct.myadvocateaurora.org

Organizations & group practices 3

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1740325984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S74W16775 JANESVILLE RD",
            "address_2": "#6",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531507742",
            "telephone_number": "414-422-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S74W16775 JANESVILLE RD",
            "address_2": "#6",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531507742",
            "telephone_number": "414-422-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "TRACY",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40401300",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tferguson42147@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "S74W16775 Janesville Rd",
            "address_2": "#6",
            "city": "Muskego",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531507742",
            "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": "S74W16775 Janesville Rd",
            "address_2": "#6",
            "city": "Muskego",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531507742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "HEINZ",
            "middle_name": "M",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Muskego, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.