Individual provider Active NPI

Andrew Wieting, DPT

  • Physical Therapist
  • West Allis, WI
National Provider Identifier
1740800606
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13891 Issued in WI
Practice address
2424 S 90TH St Ste 500
West Allis, WI 53227-2464
Phone
(414) 321-2255
Fax
(414) 321-2091
NPI assigned
Apr 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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 13891 WI Primary
Physical Medicine & Rehabilitation Physician 208100000X 13891 WI

Addresses

Primary practice location

2424 S 90TH St Ste 500
West Allis, WI 53227-2464

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 328-6640

Other identifiers 1

IdentifierTypeStateIssuer
100159406MedicaidWI

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL EPIC
Direct Messaging Address awieting184208@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
I20210318000894 WI Practitioner - Physical Therapist in Private Practice 4183031107 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Health Care Metro, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 15, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 15, 2021 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Feb 15, 2021 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Feb 15, 2021 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

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

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

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

8905 W Lincoln Ave
Ste 501
West Allis, WI 53227
Phone (414) 978-2229

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

2424 S 90th St
Ste 500
West Allis, WI 53227
Phone (414) 321-2255

8905 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Interoperability endpoints

  • Direct secure messaging: awieting184208@direct.myadvocateaurora.org

Organizations & group practices 6

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": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1740800606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 S 90TH ST STE 500",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272464",
            "telephone_number": "414-321-2255",
            "fax_number": "414-321-2091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 W Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "West Allis",
            "state": "WI",
            "postal_code": "532272409",
            "country_code": "US",
            "telephone_number": "414-328-6640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIETING",
        "first_name": "ANDREW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-21",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13891",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "13891",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100159406",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "address_1": "8901 W Lincoln Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awieting184208@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2424 S 90th St Ste 500",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272464",
            "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": "2424 S 90th St Ste 500",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.