Individual provider Active NPI

Michele Grob, PT, DPT,COMT

  • Physical Therapist
  • Brookfield, WI
National Provider Identifier
1750731352
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13422-24 Issued in WI
Practice address
3360 Gateway Rd Greenfield Rehabilitation Agency
Unit 100
Brookfield, WI 53045
Phone
(262) 923-7101
Fax
(262) 923-7178
NPI assigned
Jun 15, 2016
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 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 13422 WI
Physical Therapist 225100000X 13422-24 WI Primary

Addresses

Primary practice location

3360 Gateway Rd Greenfield Rehabilitation Agency
Unit 100
Brookfield, WI 53045

Mailing address

3360 Gateway Rd.
Unit 100
Brookfield, WI 53045
Phone (262) 352-6940

Other names 1

  • Michele Gross Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160620000246 WI Practitioner - Physical Therapist in Private Practice 1557652765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paxxon Healthcare Services LLCGroup PAC ID 8325959554, 153 clinicians

Practice addresses (Care Compare)

1550 Country Club Pkwy
Elkhorn, WI 53121-3999
Phone (262) 723-1134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13422WIMDPhysical Therapist
13422-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee LLC Physical Therapist CurrentSince Jun 13, 2016 Accepting new patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist CurrentSince Jun 13, 2016 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist Current Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17500 W Bluemound Rd
Ste B
Brookfield, WI 53045
Phone (262) 901-2800

1550 Country Club Pkwy
Elkhorn, WI 53121
Phone (262) 200-8091

S74W16867 Janesville Rd
Muskego, WI 53150
Phone (262) 971-4200

1111 E Capitol Dr
Shorewood, WI 53211
Phone (262) 293-3207

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": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1750731352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 GATEWAY RD.",
            "address_2": "UNIT 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53045",
            "telephone_number": "262-352-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 GATEWAY RD GREENFIELD REHABILITATION AGENCY",
            "address_2": "UNIT 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53045",
            "telephone_number": "262-923-7101",
            "fax_number": "262-923-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROB",
        "first_name": "MICHELE",
        "credential": "PT, DPT,COMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13422",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13422-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "GROSS",
            "credential": "PT, DPT,COMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.