Active NPI
Raymond George Herschleb, MPT
- Physical Therapist
- Milwaukee, WI
National Provider Identifier
1790767325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6020
- Practice address
- 1555 S Layton Blvd
Suite 224
Milwaukee, WI 53215-1924 - Phone
- (414) 902-2430
- Fax
- (414) 944-0002
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6020 | WI | Primary |
Addresses
Primary practice location
1555 S Layton Blvd
Suite 224
Milwaukee, WI 53215-1924
Mailing address
1555 S Layton Blvd
Suite 224
Milwaukee, WI 53215-1924
Phone (414) 902-2430
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40306800 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Associates of Wisconsin, SC | Past | Accepting new patients | |
| Medical Associates Health Centers-Occupational Health | Past | Accepting new patients | |
| Lifespeed Physical Therapy and Fitness | Physical Therapist | Past | Accepting new patients |
| Prohealth Medical Group Inc. | Past | Accepting new patients |
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.
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- NPI 1689656951
-
- Pediatrics Physician
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346284800000",
"number": "1790767325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1555 S LAYTON BLVD",
"address_2": "SUITE 224",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532151924",
"telephone_number": "414-902-2430",
"fax_number": "414-944-0002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 S LAYTON BLVD",
"address_2": "SUITE 224",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532151924",
"telephone_number": "414-902-2430",
"fax_number": "414-944-0002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERSCHLEB",
"first_name": "RAYMOND",
"middle_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2012-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "6020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40306800",
"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 Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.